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|Supreme Court Rules in King v. Burwell|
John P. Doyle, Randall B. Weill; Preti, Flaherty, Beliveau & Pachios, LLP;
July 28, 2015, previously published on June 25, 2015Today, the U.S. Supreme Court ruled 6-3 in the King v. Burwell case to uphold federal subsidies in the states where the federal government is operating the insurance Marketplace under the Affordable Care Act. The majority ruled that the literal interpretation of the provision in question did not...
|IL App Court Reinforces Broad Protection for Hospital Credentialing and Privileging Decisions|
Gregory Rastatter; Heyl, Royster, Voelker & Allen Professional Corporation;
July 28, 2015, previously published on Spring 2015In a February decision (Larsen v. Provena Hospitals), the Illinois Appellate Court, Fourth District held that for a physician whose medical staff membership was not renewed to survive dismissal in a subsequent action against the hospital, he or she must allege and prove the hospital actually or...
|Providers Applaud Supreme Court and Call on Congress to Address Remaining Issues|
James A. Dietz; Dressman Benzinger LaVelle psc;
July 24, 2015, previously published on July 17, 2015On June 25, 2015, the United States Supreme Court announced its decision upholding the provision of subsidies for individuals purchasing health insurance on federally-funded exchanges. Since then, politicians, providers, policymakers, media and advocacy groups have all offered their responses to...
|Supreme Court Rules that Affordable Care Act Law Allows Nationwide Tax Subsidies|
Julie A. Tyk; GrayRobinson, P.A.;
July 22, 2015, previously published on July 20, 2015On June 25, 2015, the Supreme Court ruled in King v. Burwell that the Affordable Care Act allows the federal government to provide nationwide subsidies to help lower-income individuals buy health insurance. Chief Justice John G. Roberts wrote the opinion for the six-justice majority. The decision...
|Personal Injury Medical Malpractice Caps Held Unconstitutional|
Julie A. Tyk; GrayRobinson, P.A.;
July 22, 2015, previously published on July 22, 2015On July 1, 2015, the Fourth District Court of Appeals (Fourth DCA) issued a major decision affecting medical malpractice cases in Florida. In the case North Broward Hospital District v. Kalitan, the court held that the caps on non-economic damages in personal injury medical malpractice cases were...
|New CMS Proposed Rule: Comprehensive Care for Joint Replacement|
Claire E. Castles, Catherine A. Ehrgott, Lisa Ge Shang Han, David T. Morris; Jones Day;
July 16, 2015, previously published on July 15, 2015On July 9, 2015, the Centers for Medicare & Medicaid Services ("CMS") announced a proposed rule to test a new payment model, the Comprehensive Care for Joint Replacement ("CCJR"), for hip and knee replacements (also called lower extremity joint replacements or...
|Closing a Practice: How to Prepare for Death, Disability and Retirement|
Scott D. Hammer; Wilson Elser Moskowitz Edelman & Dicker LLP;
July 16, 2015, previously published on July 2015Believe it or not, the chances of becoming disabled, dying or retiring are pretty good. Although some therapists believe their therapeutic efficacy will lead to immortality, I hate to tell you, but one day your caring heart will cease beating. Either death or your patients will eventually kill you....
|Trinity Homecare Settlement: Five False Claims Trends|
Mintz Levin Cohn Ferris Glovsky Popeo P.C.;
July 16, 2015, previously published on July 15, 2015New York State Attorney General Eric Schneiderman recently announced that his office had reached a $2.5 million settlement in a federal False Claims Act (FCA) case with Trinity HomeCare and its related entities. The case, filed as a qui tam action in federal district court in the Eastern District...
|CMS Proposes Easing Two-Midnight Restrictions (But 2016 OPPS Rule Is Not All Good News)|
David W. Grauer, Rebekah N. Plowman, Elizabeth E. Trende; Jones Day;
July 16, 2015, previously published on July 2015On July 8, 2015, the Centers for Medicare and Medicaid Services ("CMS") issued the 2016 proposed rule for the Hospital Outpatient Prospective Payment System ("OPPS") and Ambulatory Surgery Center ("ASC") payment system ("Proposed Rule"). While the Proposed...
|CMS Talks Sense for Stark Compliance under Proposed 2016 Medicare Physician Fee Schedule|
Laurel E. Baum, Jennifer R. Bolster, Raymond R. D'Agostino, Catherine A. Diviney, Meghan S. Gaffey; Hancock Estabrook, LLP;
July 16, 2015, previously published on July 2015On July 8, 2015, the Centers for Medicare & Medicaid Services (“CMS”) released a proposed rule that could provide some much needed breathing room for inadvertent lapses in Stark law compliance. By way of background, the physician self-referral or “Stark” law governs...