January 31, 2012
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Health care providers continue to face high leveles of scrutiny from CMS, a variety of auditors and recovery contractors, and state and federal law enforcement. Polsinelli Shughart Shareholders Jeffrey Fitzgerald and Daniel Reinberg will present a free webinar February 21, 2012, on "Fraud and Abuse: A Year in Review."
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January 27, 2012
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Top performers in the health care deal community from across the nation will gather to share the latest strategies, trends and approaches to creative deal making. This conference is the venue in the Southwest for peer to peer networking among healthcare company executives and the providers of capital and advisors who support their deal making.
Our Dallas shareholder Jon Henderson is the founding chair of the event, now in its fifth year.
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December 19, 2011
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The Internal Revenue Service (IRS) has released a draft version of the 2011 Form 990, Schedule H, Hospitals and its instructions.
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December 6, 2011
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Join us in Denver January 10 for the 2012 Health Care Regulatory Update. Hear Polsinelli Shughart presenters speak on significant legal and regulatory changes that are important to health care facilities.
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December 6, 2011
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The U.S. Department of Health and Human Services (HHS) Office of the Inspector General (OIG) issued its FY 2012 Work Plan recently, which outlines the new and ongoing reviews and activities that the OIG plans to pursue with respect to HHS programs and operations.
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December 2, 2011
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The Health Care Innovation Challenge is a funding opportunity for compelling new models of delivery and payment that hold the promise of better health, better health care and lower costs for Medicare, Medicaid and the Children's Health Insurance Program.
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November 14, 201
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The U.S. Supreme Court announced today it will hear a legal challenge to the Patient Protection and Affordable Care Act (PPACA), President Obama's health reform legislation Congress enacted in March 2010.
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November 4, 2011
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Click on the link for a high-level summary of the Final Rules related to Section 3022 of the Patient Protection and Affordable Care Act and the "shared savings" program. In addition you may access a recording of a webinar presented by Polsinelli Shughart Health Care attorneys on the Final Rule.
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October 25, 2011
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Join us for a webinar Monday, October 31, focused on the important changes made to the CMS final rules to implement Accountable Care Organizations.
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October 19, 2011
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September 23, 2011
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The new Centers for Medicare and Medicaid Services (CMS) 2012 Final Rule for the Inpatient Prospective Payment System includes several adjustments to payment rates as well as changes to existing regulations.
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August 15, 2011
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On July 18, The Department of Health and Human Services issued a proposed rule to implement the Consumer Operated and Oriented Plan (CO-OP) program (CMS-9983-P). This program will provide loans to capitalize consumer-governed, private, nonprofit health insurance issuers to enable them to offer qualified health plans by means of Affordable Insurance Exchanges (Exchanges). There is to be at least one CO-OP in every state in order to expand the number of health plans available in the Exchanges, which are scheduled to commence operations in 2014.
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July 29, 2011
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The IRS has issued guidance on the community health needs assessment (CHNA) requirements imposed on tax-exempt hospital organizations.
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July 14, 2011
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The Centers for Medicare and Medicaid (CMS) released its final rule making changes to Medicare Conditions of Participation for hospitals and critical access hospitals to create a new process for the credentialing and privileging of telemedicine practitioners.
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June 22, 2011
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The Department of Health and Human Services has released a notice of proposed rulemaking (NPRM) to implement the statutory requirement under the Health Information Technology for Economic and Clinical Health Act. HHS is seeking comments from the public through August 1, 2011, which will be considered by HHS prior to finalizing the new requirements.
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May 13, 2011
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The Federal Register published the Final Rule regarding the implementation of the hospital value-based purchasing (VBP) program after the Centers for Medicare & Medicaid Services released the Final Rule in April 2011. Hospitals must act now if they wish to have the greatest chance at reimbursement under the VBP program.
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April 26, 2011
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In August 2010, the Financial Accounting Standards Board (FASB) released its Proposed Accounting Standards Update on Leases which, if enacted, would have essentially eliminated the concept of an operating lease and required recognition of all leases on the balance sheet. For many of our clients, this change would have impacted balance sheets, debt covenants and future real estate transactions. FASB and IASB, after further deliberation and discussion, intend to issue a final standard for leases later in 2011. Health care providers should consult with their legal advisors and their accountants before the effective date of the final rules in order to understand the consequences of such changes.
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April 25, 2011
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The proposed rule implementing the Medicare Accountable Care Organization (ACO) Program (also referred to as the Shared Services Program) raises many questions and concerns among healthcare stakeholders.
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April 6, 2011
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This e-Alert contains a summary of the basic design elements of Accountable Care Organizations (ACOs) as set out in the Centers for Medicare & Medicaid Services proposed rule implementing the Medicare Shared Savings Program.
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March 31, 2011
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Today the Centers for Medicare and Medicaid Services (CMS) released the proposed rule that will govern the implementation of section 3022 Medicare Shared Savings Program (Program) of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010 (together referred to as ACA). The Program is intended to promote accountability for a patient population, coordinate care under parts A and B, and encourage investment in infrastructure and care processes that result in the delivery of services through Accountable Care Organizations (ACOs) that meet quality, cost and efficiency metrics.
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March 15, 2011
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Recent events signal that the government was not bluffing in signaling increased enforcement of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). In the Health Information Technology for Economic and Clinical Health (HITECH) Act, which was enacted as part of the American Recovery and Reinvestment Act of 2009, emphasis was put on increased enforcement of HIPAA by providing for a tiered increase in the penalties that may be levied against an entity that violates HIPAA. Penalties could run between $100 and $50,000 for each violation, and $25,000 and $1.5 million per year.
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March 2011
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March 14, 2011
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In spite of media stories implying health reform law is well on its way to being “de-funded,” that is not the case. Congress is not repealing health reform legislation. A number of provisions and reductions of funding for programs are in store but the basic structure of the legislation will remain largely intact.
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January 19, 2011
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The Centers for Medicare & Medicaid Services issued a proposed rule regarding Medicare's Value Based Purchasing (VBP) Program to reward hospitals for providing high quality, safe patient care. Hospitals must act now if they wish to have the greatest chance at reimbursement under the VBP Program.
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December 1, 2010
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The Centers for Medicare and Medicaid Services released the final rule on hospital visitation that allows patients to designate their own visitors during a hospital stay. The rule, which will apply to any hospital that participates in Medicare or Medicaid, will go into effect January 16, 2011.
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November 2010
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November 3, 2010
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The Environmental Protection Agency (EPA) recently issued a draft guidance document describing methods for health care faculties to legally manage and dispose of unused pharmaceuticals and avoid violating federal or state laws.
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September 2010
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September 10, 2010
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On August 20, 2010, the Illinois Court of Appeals confirmed that the Illinois Department of Public Health (IDPH) faces a mandatory time frame to determine a licensure violation after a survey. Anytime a facility receives a notice from IDPH of state licensure violations and fines, the facility should carefully check the dates and time frame of IDPH's determination.
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August 23, 2010
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In recent weeks, there have been a number of reports and developments relating to the Illinois Health Facilities and Services Review Board (the CON Board) including new CON Board member appointments and the issuance of two reports which the CON Board is now mandated to produce and disclose to the public.
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August 2010
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July 23, 2010
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On June 18, 2010, the Illinois Department of Public Health issued a Notice of Proposed Amendments to the Hospital Licensing Requirements, which implements two statutes enacted by the Illinois General Assembly in 2009.
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July 20, 2010
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The Centers for Medicare and Medicaid Services (CMS) have released the Final Rule for the Medicare and Medicaid Electronic Health Record (EHR) Incentive Program (the Meaningful Use Final Rule). Simultaneously, the Office of the National Coordinator for Health Information Technology (ONC) released its Final Rule addressing certification criteria for EHRs (the Certification Criteria Final Rule). These two Final Rules establish what criteria and technical standards constitute the meaningful use of EHR technology and establish eligibility for incentive payments.
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July 8, 2010
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On June 25, 2010, President Obama signed The Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 into law. The Act provides a six-month delay of earlier legislation which, effective June 1, 2010, imposed a 21 percent reduction in reimbursement under the Medicare Physician Fee Schedule (MPFS). The Act also increases MPFS reimbursement by 2.2 percent through November 30, 2010.
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June 8, 2010
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The popular Polsinelli Shughart Health Care Breakfast Series returns with an opportunity to ask questions of lawyers in the firm's Health Care Law practice. During the complimentary breakfast event, attendees will gain perspective on how providers are navigating complicated reimbursement issues and creating business opportunities.
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June 8, 2010
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On April 13, 2010, the Joint Committee on Administrative Rules adopted amended Health Facilities and Services Review Board Administrative Rules (Amended Rules). The Amended Rules are effective for all certificate of need applications filed on or after April 13, 2010. The two most notable changes to the Amended Rules are the addition of charity care as a new criterion on the certificate of need application and waiver criteria for the financial viability requirements.
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June 2010
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The Illinois Department of Public Health (IDPH) recently expanded the Hospital Report Card and Consumer Guide to Health Care Web site by updating and adding new categories of data. The Hospital Report Card and Consumer Guide to Health Care Web site was originally launched in November 2009 as part of the implementation of the Hospital Report Card Act (210 ILCS 86). Under this legislation, all Illinois hospitals are required to report quality data regarding nursing care and infection control on a quarterly basis to the IDPH.
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June 1, 2010
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Steven K. Stranne and Alan K. Parver, Shareholders with Polsinelli Shughart PC, will provide a framework for understanding the new law and the ongoing trends in reimbursement, coverage, coding and funding for medical devices during a complimentary webinar event June 9.
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May 25, 2010
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On March 18, 2010, the Joint Commission issued the revised Medical Staff standard MS.01.01.01, which was originally known as MS.1.20. This standard addresses the governance structure of the Medical Staff and its accountability to the hospital's Governing body.
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May 2010
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04/29/2010
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Bruce R. Hopkins and Douglas K. Anning of Polsinelli Shughart's Nonprofit Organizations group presented a special webinar April 29 on the landmark Patient Protection and Affordable Care Act and its implications for nonprofit organizations. Click on the headline above and follow the instructions to view the webinar in its entirety.
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04/16/10
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The landmark Patient Protection and Affordable Care Act signed by President Obama has relevance for nonprofit organizations, principally hospitals. The new developments in the tax-exempt arena may leave organizations struggling to understand and comply. Bruce R. Hopkins and Douglas K. Anning of Polsinelli Shughart's Nonprofit Organizations group have analyzed the new legislation and will share important implications for your nonprofit organization in a special complementary one-hour webinar event April 29.
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March 2010
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February 25, 2010
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As part of the Health Information Technology for Economic and Clinical Health Act, the Office of the National Coordinator for Health Information Technology (ONCHIT) released on December 30, 2009, an Interim Final Rule (IFR) that was published in the Federal Register on January 13. That IFR detailed the initial set of standards, implementation specifications and certifications criteria that must be achieved in order to demonstrate the first stage of the "meaningful use" of electronic health record (EHR) technology and, by doing so, establish eligibility for various incentive programs.
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February 10, 2010
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Advisory board members of BNA's Health Law Reporter, including Polsinelli Shughart Shareholder Fred Entin, have released their annual outlook report, identifying the top 10 health law issues organizations should be aware of during the coming year, and commenting on what changes, if any, are likely to occur. While the recent Senate election in Massachusetts has created uncertainty about whether reform measures might be passed by Congress this year, health care reform continues to be a very important issue.
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January 28, 2010
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The Health Information Technology for Economic and Clinical Health Act (HITECH), which was included as part of the American Recovery and Reinvestment Act of 2009, created three incentive programs targeted at eligible health care professionals and hospitals that can demonstrate “meaningful use” of electronic health records (EHR). These programs provide payment incentives in the Medicare Fee-for-Service (FFS), Medicare Advantage (MA) and Medicaid programs. In order for hospitals and health care professionals to take full advantage of the EHR incentive programs, it is important to learn and understand the eligibility criteria and how to meet them.
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December 1, 2009
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On October 30, 2009, the Federal Trade Commission (FTC) delayed the enforcement date of the “Red Flag Rules” for the third time - until June 1, 2010. The Red Flag Rules require the implementation of a written compliance program to provide for the identification and detection of, and response to patterns, practices, or specific activities (red flags), that could indicate identity theft.
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November 24, 2009
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On October 30, 2009, the Centers for Medicare and Medicaid Services released the final rules for 2010 addressing the Outpatient Prospective Payment System (OPPS Final Rule) and the Physician Fee Schedule (PFS Final Rule). Combined, the two final rules and commentary comprise over 3,500 pages and address a variety of issues related to the payment system for hospital outpatient departments and physician practices.
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November 6, 2009
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On October 30, 2009, the U.S. Department of Health and Human Services (HHS), through the Office for Civil Rights (OCR), issued an interim final rule (Rule) to conform current regulations addressing Civil Money Penalties (CMPs) for violations of the HIPAA regulations to the statutory amendments made pursuant to the Health Information Technology for Economic and Clinical Health Act (HITECH), which was enacted as part of the American Recovery and Reinvestment Act of 2009 (ARRA).
HHS invited public comments to the interim final rules until December 29, 2009. The interim final rule becomes effective on November 30, 2009, and HHS will consider all public comments to the interim final rule that it receives through December 29, 2009.
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October 23, 2009
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On October 1, 2009, the Office of Inspector General (OIG) published its Work Plan for 2010. The Work Plan identifies new, continued and revived programs and activities that will be the focus of the OIG in 2010. Health care providers should use the Work Plan as a reference guide to identify potential corporate compliance risk areas, update current policies and programs and determine the scope and focus of its annual audit plan.
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September 29, 2009
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On September 24, 2009, Governor Jay Nixon issued an executive order to examine the issues relating to timely reimbursement of Missouri hospitals and healthcare providers by health insurance companies. This update from Polsinelli Shughart's Health Care group provides information on the project and its effects on hospitals and providers.
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September 8, 2009
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New regulations, which apply to vendors who offer individuals a place to electronically store their personal health record, as well as, health care providers, health plans and clearinghouses who transmit health information electronically, expand the reach of HIPAA and federal privacy rules. With an increase in civil money penalties as well, it is important that organizations have accurate information about what is required and what the remedies are for not meeting the requirements.
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August 21, 2009
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A new CMS manual change which will significantly affect "consignment closet" or "stock and bill" arrangements between physicians and non-physician practitioners and DMEPOS suppliers. These changes are usually made by regulation and provide the practitioners with notice of the impending change. However, this change could require significant restructuring of existing arrangements and has been adopted by manual change with an effective date of September 8, 2009.
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August 10, 2009
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Consolidating medical groups into large-scale physician practices is the wave of the future and will ultimately increase patient access to healthcare. Randal L. Schultz, vice chair of the Polsinelli Shughart Health Care group, will address the topic at a September 13 presentation to the Medical Development Specialists (MDS) Annual Conference in Las Vegas, Nevada.
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June 18, 2009
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The substantive and procedural changes to the civil False Claims Act (FCA) sweep broadly and will affect many health care providers, as well as other industry groups. Health care providers need to review their compliance programs and ensure such programs reflect the recent changes in the FCA.
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May 19, 2009
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Effective May 18, 2009, any Ambulatory Surgical Center (ASC) that has an agreement with Centers for Medicare and Medicaid Services (CMS) to participate in Medicare as an ASC must meet new notice provisions for patients of the ASC. The notice provisions set forth in the conditions for coverage require the ASC to provide to all patients (whether Medicare or private pay patients) or their representatives, in advance of the date of the procedure certain information.
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May 7, 2009
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On April 22, 2009, the U.S. Department of Health and Human Services, Office of Inspector General (OIG) released a report finding nursing home corporations under quality of care corporate integrity agreements (CIAs) enhanced their quality of care structures and processes by integrating quality into their compliance programs. This report supports the fact that quality can be improved by integrating it with compliance.
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April 20, 2009
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Signed into law by President Obama on February 17, 2009, the American Recovery and Reinvestment Act (The Act) is intended to spur a significant change in the nation’s economic downturn. While The Act includes federal tax cuts and domestic spending in areas such as health care, it also includes non-economic recovery items such as a study on the effectiveness of medical treatments, which was a part of longer-term plans.
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February 13, 2009
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With a struggling economy and a new president promising action, the stage is set for changes in the nation’s health care system. Advisory board members of BNA’s Health Law Reporter, including Polsinelli Shughart attorney Fred Entin, have released their annual outlook report, identifying the top 10 health law issues organizations should be aware of during the coming year, and commented on what changes, if any, are likely to occur.
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