Health Law Alert

The Jimmo v. Sebelius case, settled in 2013, clarified Medicare coverage of nursing services and therapy to prevent deterioration, the so-called “maintenance coverage” standard.  The clarification was necessary to dispense with a long-held erroneous belief that Medicare only covered nursing and therapy services when the beneficiary was expected to improve.  Ironically, there […]

On August 2, 2017, in the 2018 Medicare Hospital Inpatient Prospective Payment System and Long Term Acute Care Hospital Prospective Payment System Final Rule (the “Final Rule”), the Centers for Medicare and Medicaid Services (“CMS”) released changes to the Medicare and Medicaid Electronic Health Record Incentive Program (“Meaningful Use”).  The […]

In the May 23, 2017 decision in the case of Computer Support Services (d/b/a Cyzap) v. Vaccination Services (d/b/a TotalWellness), the Nebraska Court of Appeals considered whether a liquidated damages provision in a contract was enforceable.  In this case, an IT vendor called Cyzap had entered into an arrangement with […]

On July 13, 2017, CMS issued the 2018 Proposed Rules governing the outpatient prospective payment system and ambulatory surgery prospective payment system.  The Proposed Rules include a number of proposed policy changes which are subject to comment until September 11, 2017.  A final rule is expected to be published on […]

Whenever a hospital medical staff makes a decision that adversely affects a member’s privileges, it needs to determine whether to report the decision to the National Practitioner Data Bank (“NPDB”).  Those decisions can be surprisingly complex, as a recent Federal case highlights, and may depend on the wording of the […]