If yours is one of the small clinical practices with less than $30,000 in Medicare revenue or fewer than 100 unique Medicare patients per year, October 2, 2017 will be just another Monday. However, for most Medicare-participating health care practitioners, Monday,...

Nursing homes and skilled nursing facilities ("SNF") should be aware that they will be in the crosshairs of the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) in 2017. As part of this year's Annual Work Plan, OIG has identified...

In 1987, the Nursing Home Reform Act ("NHRA") was passed to ensure that residents of nursing homes would receive quality care at all times in order to achieve and maintain their "highest practicable" physical, mental and psychosocial well-being. With the law came...

The Affordable Care Act ("ACA") created both tax credits to make health insurance premiums more affordable and cost-sharing reductions intended to reduce deductibles, coinsurance, and co-pays. According to the ACA, insurers are required to reduce the cost-sharing of...

If you work in the health care field, in any capacity, you have surely heard of the Health Insurance Portability and Accountability Act, or "HIPAA;" and if you or your business create, use, disclose or accept protected health information ("PHI"), you are likely a...

On December 28, 2015, by way of Notice 2016-4, the Department of the Treasury and the Internal Revenue Service ("IRS") extended the due dates for 2015 information reporting pursuant to the Affordable Care Act ("ACA"). Noting that some insurers and employers need...

If you employed 50 or more full-time employees (including full-time equivalent employees) in 2015, you are an "Applicable Large Employer" or "ALE" in accordance with the Affordable Care Act's ("ACA") Employer Shared Responsibility provisions under Section 4980H of the...

The Health Insurance Portability and Accountability Act ("HIPAA") Privacy Rule generally prohibits covered entities and their business associates from disclosing protected health information ("PHI") unless there is a valid written authorization or a specific exception...

An administrative law judge ("ALJ") recently upheld the revocation of a Medicare Home Health Agency's ("HHA") billing privileges, based on the fact that the HHA did not properly notify CMS of a practice location change. 42 C.F.R. Section 424.516(e), requires certain...

Health care providers should be aware of a proposed rule recently issued by the Centers for Medicare & Medicaid Services (CMS) that expands the regulations governing physician self-referrals, (the "Stark Law"). The Stark Law prohibits a physician from making...