Health Care Law Blog

Medicare Provider-Supplier Revalidation: Are You Ready?

All providers and suppliers that were enrolled with the Medicare program prior to March 25, 2011 will be asked to revalidate their enrollment information in the near future.  According to a statement issued by the Department of Health and Human Services' Centers for Medicare and Medicaid Services ("CMS"), intermediaries will begin contacting providers and suppliers to do the following: Read More ›

Categories: Billing/Payment, Health Care Reform, Hospitals, Medicare/Medicaid, Physicians

Posted by: Jennifer Kildea Dewane

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Score Tied: Health Reform - 1, Opponents - 1

The 11^th Circuit Court of Appeals recently issued a decision declaring that the "individual mandate" provisions of the Patient Protection and Affordable Care Act ("PPACA") are unconstitutional.  This decision directly conflicts with the decision issued by the 6^th Circuit Court of Appeals earlier this summer. Read More ›

Categories: Health Care Reform, Hospitals, Insurance, Physicians

Posted by: Mindi M. Johnson

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CMS Discarding Unanswered FOIA Requests

The Centers for Medicare and Medicaid Services ("CMS"), like other federal agencies, generally has 20 days (plus a 10 day extension) to respond to requests for information under the Freedom of Information Act ("FOIA").  However, CMS responses seem to take quite a bit longer.

Last week, I received a response to a FOIA request that I filed with CMS in March of 2010.  That's right: 2010.  In its response, CMS explained that when it is busy, it utilizes a "first-in, first-out" approach when responding to requests. Read More ›

Categories: Hospitals, Physicians, Regulatory

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Braving the New Frontier of Accountable Care Organizations

On May 17, 2011, the Center for Medicare and Medicaid Innovation, a part of the Centers for Medicare & Medicaid Services ("CMS"), announced a "Pioneer ACO Model" designed for providers that are already experienced in coordinating care for patients across care settings.

The Pioneer ACO program provides higher risks and greater rewards in the first two years of the program than those available to non-Pioneer Accountable Care Organizations ("ACOs"). Specifically, non-Pioneer ACOs can choose from two tracks that vary on risk and reward under the CMS proposed ACO regulations.  Track One ACOs are those involved in a “one-sided model” that begins as a no-risk shared-savings payment system for the first two years and converts to a risk-sharing payment system in the third year. Track Two ACOs are those that are involved in a "two-sided model,” with risk-sharing (of both savings and losses) beginning in year one. Pioneer ACOs also participate in two-sided risk sharing from year one. Read More ›

Categories: Accountable Care Organizations, Health Care Reform, Hospitals

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Physician-Patient Privilege Restricts Enforcement of Non-Compete and Non-Solicitation Clauses in Physician Employment and Practice Agreements

A recent decision by the Michigan Court of Appeals imposes a substantial obstacle to enforcing contracts that prohibit physicians from soliciting or servicing patients after leaving employment or separating from a practice. Steiner v Bonanni (decided April 7, 2011). Read More ›

Categories: Employment, HIPAA, Hospitals, Physicians

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Reorganization of the Department of Energy, Labor, and Economic Growth will Impact Health Care Providers

Through Executive Order 2011-4 ("Order"), Governor Snyder has ordered that the Department of Energy, Labor and Economic Growth be reorganized and renamed the Department of Licensing and Regulatory Affairs, effective as of April 24, 2011.  Especially important to those in the health care industry is the fact that the Bureau of Health Professions, the Bureau of Health Systems and the Controlled Substances Advisory Commission will be transferred from the Department of Community Health ("MDCH") to the Department of Licensing and Regulatory Affairs.  The Governor announced that the transfer will allow MDCH to concentrate on the actual health care delivery aspects of its duties while allowing Licensing and Regulatory Affairs to oversee the licensing and professional regulatory aspects of these functions.  Read More ›

Categories: Hospitals, Physicians

Posted by: Jennifer Kildea Dewane

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Doctors Soon Will Be Allowed to Say "I'm Sorry"

The Michigan House of Representatives and Senate have both recently approved versions of what's been termed the "I'm Sorry Bill."  The Bill provides that certain statements expressing sympathy, compassion, commiseration, or a general sense of benevolence relating to pain, suffering, or death of an individual are inadmissible as evidence of an admission of liability in a medical malpractice action.  However, statements of fault, negligence or culpable conduct would remain admissible.  Read More ›

Categories: Hospitals

Posted by: Mindi M. Johnson

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Lowering Single Business Tax Liability

Pamela Dusman recently had a significant victory in the Michigan Court of Appeals on behalf of a hospital client.  The hospital client, in calculating its single business tax liability, specifically its "unrelated taxable income," on its Michigan Single Business Tax Return claimed a capital acquisition deduction and an investment tax credit for its capital assets regardless of whether the assets were used for tax-exempt or non-exempt activities.  The Michigan Tax Tribunal upheld the hospital's position, holding that the hospital did not need to allocate its assets between exempt and non-exempt uses when claiming the capital acquisition deduction or the investment tax credit.  This reading of the Single Business Tax Act was upheld by the Michigan Court of Appeals on February 15, 2011.  Although the Single Business Tax Act was repealed by the legislature for tax years that begin after December 31, 2007, an entity's Single Business Tax Return may be amended within four years after the due date of the original return.  This decision can have a significant impact on lowering single business tax liability on unrelated business income for tax-exempt providers. 

Categories: Hospitals, Tax

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Now's the Time to Upgrade to Electronic Health Records with Incentive Registration

Registration for the electronic health record ("EHR") incentive programs with Medicare and Medicaid in Michigan began on January 3, 2011.  Hospitals, critical access hospitals, and professionals who register and can demonstrate "meaningful use" of certified EHR programs  within the extensive guidelines of the Centers for Medicare & Medicaid Services ("CMS") are eligible for the incentives.  Read More ›

Categories: HITECH Act, Hospitals

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New Blue Cross Class Action Lawsuit Implicates Hospitals

On January 21, 2011, the City of Pontiac filed a class action lawsuit against Blue Cross Blue Shield of Michigan ("Blue Cross") and 21 hospitals and health systems (collectively, the "Hospital Defendants").  The complaint alleged that Blue Cross unlawfully restrained trade in violation of the Sherman Act and Michigan Antitrust Reform Act by including 'most favored nation' ("MFN") clauses in its contracts with hospitals.  (The effect of these clauses was to allegedly raise the minimum prices that hospitals could charge to Blue Cross' competitors.) Read More ›

Categories: Billing/Payment, Hospitals

Posted by: Mindi M. Johnson

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