Stories can be powerful tools. Stories can create a sense of connection and have the power to shape the lives of both the storyteller and the listener. Stories also make ideas and experiences relatable and can encourage exploration or action. And it was the stories I heard from members of AHLA’s Women’s Leadership Council that inspired me to write this column as a reminder of the incredible impact of AHLA’s educational mission supported by AHLA’s philanthropic initiatives.
On July 26, 2022, Judge Jeremy Kernodle of the Eastern District of Texas affirmed that certain parts of the Interim Final Rule Part II implementing the No Surprises Act (the Act) were invalid. This ruling is nearly identical to Judge Kernodle’s February decision in Texas Medical Association & Corley v. US Dept. of Health and Human Services. This decision vacated a portion of the Interim Final Rule that required arbitrators to give more weight to the out-of-network rate, including what is called the Qualified Payment Amount (QPA), over other permissible factors. The rule’s requirement ultimately contradicted the Act’s direction that arbitrators consider various factors, and not weight any one more heavily than another.
Workplace violence has become a hot topic in today’s discourse; however, workplace violence is not just headline fodder for media outlets. The trend is well-documented and especially felt by the healthcare industry which continues to experience the brunt after the onslaught of COVID-19. In 2018, 73% of all nonfatal workplace violence incidents involved healthcare workers. A late 2020 survey reported that 20% of nurses reported they were facing an increase in workplace violence after the COVID-19 pandemic began. Another study reported a 14.6% increase in workplace violence at New Jersey hospitals over the prior three years.
As the health care industry shifts from fee-for-service to value-based arrangements, providers are facing a lot of challenges. A provider’s relationship with payers is often strained by the new business model, and a provider’s ability to collaborate with payers has never been more important.
On this episode of Value-Based Care Insights, host Daniel J. Marino
When confronted with a complaint, allegation or event that implicates a potential Medicare overpayment, hospices have an affirmative duty under the federal 60-day repayment rule to conduct an investigation and refund any overpayment. In this episode, Husch Blackwell’s Meg Pekarske and Andrew Brenton share tips and tools for conducting internal investigations and determining when an
The American Health Law Association released its Special Edition of its Journal of Health and Life Sciences Law on Emerging Issues in Health Equity in the United State: Legal, Legislative, and Policy Perspectives. The association strives to advance public discourse on these issues for the benefit of AHLA members, the public, academia, and decision makers in both the legislative and executive branches of government.
The U.S. Department of Justice’s recent criminal prosecutions of health care executives for no-poach and wage-fixing conspiracies have been met with not-guilty verdicts. Despite these losses, the Department continues to prosecute this conduct, and antitrust enforcers will continue to investigate human resources practices that may restrain competition.
The Acute Care Hospital at Home model (ACHAH) provides traditional hospital inpatient acute-level services at home. Prior to the pandemic a Centers for Medicare and Medicaid pilot study yielded positive results with respect to hospital readmission rates and follow-up emergency department visits. The ACHAH model appears to be a feasible alternative to traditional inpatient acute care that can improve quality of care and patient satisfaction. What was previously a trickle of interest turned into a wave of necessity as the pandemic overwhelmed hospitals and the health care system in 2020. In response to the pandemic, CMS began to provide hospital with broad regulatory flexibility to implement the ACHAH model.
On March 23, 2022, the Occupational Safety and Health Administration (OSHA) published a notice in the federal register announcing a limited re-opening of the comment period regarding OSHA’s final standard to protect healthcare and healthcare support service workers from occupational exposure to COVID-19. The comment period will end on April 22, 2022, and the virtual public hearing will be held on April 27, 2022. The Emergency Temporary Standard (ETS) for Occupational Exposure to COVID-19 for healthcare and healthcare support service workers (OSHA Healthcare ETS) was originally published on June 21, 2021. OSHA has re-opened the comment period to allow stakeholders to address changes the agency is considering that depart from the June 2021 version of the OSHA Healthcare ETS.
Throughout the COVID pandemic, healthcare employers have navigated the challenge of balancing safety concerns with employee requests for religious exemption from the vaccine. Since lifting the stay of the CMS rule requiring certain healthcare workers to receive a COVID-19 vaccine, the US Supreme Court (Court) has refused to enjoin state and city vaccine mandates for workers who seek religious exemptions from such mandates. On March 7, 2022, the full Court rejected, without comment, an emergency application for an injunction that was previously denied by Justice Sotomayor to prevent enforcement of the New York City Department of Education’s COVID-19 mandate against suspended workers who refused vaccination based on religion. In the wake of continued challenges to vaccine mandates based on religion, the U.S. Equal Employment Opportunity Commission (“EEOC”), released guidance on March 1, 2022 that addresses questions related to religious objections to vaccinations in the workplace. Healthcare employers should ensure that assessment of requests for religious exemptions for vaccine mandates comports with EEOC guidance.