Hospitals
Miles & Peters assists hospitals in navigating through the complex
state and federal regulatory environment. The firm provides representation
for all aspects of facility operation and management, such as regulations
involving licenses, certification, business transactions, contracts, labor
and employment, and sales and acquisitions.
Click below for News and Information regarding:
CMS PROPOSES REVISIONS
TO HOSPITAL CONDITIONS OF PARTICIPATION
CMS issued March 24 a proposed rule that would revise certain requirements
in hospital conditions of participation (CoPs). The revisions focused on
hospital CoPs for competition of history and physical examinations, authentication
of verbal orders, securing medications, and completion of post anesthesia
evaluations.
For more information go to www.cms.hhs.gov to
read the proposed rule in the March 25 Federal Register , go to www.healthlawyers.org/docs.ask2005/70FR_15266.pdf.
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DHHS OIG APPROVES COST SAVINGS SHARING
ARRANGEMENT BETWEEN SURGEONS AND HOSPITAL
In Advisory Opinion No. 05-01 released on February
4, the DHHS Office of Inspector General (OIG) said a proposal by a hospital
to share with a group of cardiac surgeons a percentage of the hospital’s
cost savings arising from the surgeons’ implementation of cost reduction
measures for certain surgical procedures could potentially generate prohibited
remuneration under the Anti-Kickback Statute, but that it would not impose
administrative sanctions in connection with the arrangement.
To read the Advisory Opinion, go to www.healthlawyers.org/docs/ask2005/AO_0501.pdf.
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CONGRESS SHOULD EXTEND
SPECIALTY HOSPITAL MORATORIUM PENDING FURTHER REVIEW, MEDPAC ADVISES
Congress should extend the current moratorium on the development
of new specialty hospitals through January 1, 2007, the Medicare Payment
Advisory Commission (MedPAC) recommended in its latest report on the issue.
MedPAC said the extension is needed to allow further study on the effect
of these limited service facilities. At the same time, MedPAC also recommended
changes to the way Medicare reimburses hospitals for inpatient services “to
improve the accuracy of the recommended changes to the way Medicare reimburses
hospitals for inpatient services “to improve the accuracy of the payment
system and thus reduce opportunities for hospitals to benefit from selection.
Meanwhile, the House Ways and Means Subcommittee on Health and the Senate
Finance Committee held hearing on the specialty hospital issue at which Senate
Finance Committee Ranking Minority Member Max Baucus (D-MT) expressed concern
that “when it comes to physician ownership of speciality hospitals,
I’m not sure the playing field is level.”
For more information on the Senate finance Committee hearing, go to http://www.finance.senate.gov/sitepages/hearing030805.htm.
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OIG ADDRESSES GAIN-SHARING
ARRANGEMENTS IN RECENT ADVISORY OPINIONS
In February 2005, the U.S. Department of Health and Human Services Office
of Inspector General (OIG) released a series of Advisory Opinions that provide
guidance to hospitals on structuring gain-sharing arrangements with physicians.
The opinions mark the latest in a series of OIG pronouncements on gain-sharing
over the last several years. While the opinions continue to express the OIG’s
longstanding view that such arrangements could lead to reductions in care
and allow hospitals to generate kickback type payments to physicians, the
opinions also reveal that gain-sharing arrangements containing certain features
will not be subject to enforcement action by the OIG.
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THE NEW OIG ENFORCEMENT
GUIDANCE FOR HOSPITALS
On January 27, 2005, the United States Department of Health and Human Services
(DHHS) Office of Inspector General (OIG) released its revised “Supplemental
Compliance Program Guidance for Hospitals” (Guidance). The new Guidance
supplements the OIG’s 1998 hospital compliance program guidance. Compliance
officers, in-house counsel, and hospital management can use the Guidance
to target their audit efforts, as well as to develop a better understanding
of the OIG’s current interpretations of healthcare enforcement laws
and regulations.
http://oig.hhs.gov/fraud/docs/complianceguidance/
012705HospSupplementalGuidance.pdf
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DOJ
OFFERS GUIDANCE ON NONDISCRIMINATION AGAINST
LIMITED ENGLISH SPEAKERS
The Civil Rights Division of the U.S. Department of Justice issued guidance
October 26 on what recipients of federal assistance-including hospitals-must
do to ensure they are not discriminating against those with limited English
proficiency.
The guidance is online at www.usdoj.gov/crt/cor/lep/Oct26Memorandum.htm.
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CMS PUBLISHES NATIONAL PROVIDER
IDENTIFIER FINAL RULE
On January 23, 2004 CMS published the long awaited National Provider Identifier
(NPT) final rule. This NPT final rule requires all health care organizations
to use an assigned identifier for each health care provider when filing and
processing electronic claims and other standard transactions.
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