After missing several self-imposed deadlines to release new FLSA wage and hour regulations called for by President Obama, the DOL released proposed rules on Monday that will dramatically increase the number of employees eligible for overtime payments. As expected, the proposed changes focus primarily on the salary threshold for the “white-collar” exemptions to the overtime provisions of the FLSA.
Husch Blackwell No. 7 among Modern Healthcare’s largest healthcare law firms; No. 5 on AHLA’s list
National healthcare publication Modern Healthcare yesterday announced Husch Blackwell LLP is the seventh-largest healthcare law firm in the U.S. according to its 2015 rankings, up from No. 12 last year. Utilizing differing measurement techniques, American Health Lawyers Association also ranked healthcare practices, placing Husch Blackwell as fifth-largest in the country in its 2015 list, released…
Children’s hospital to pay $12.9 million to settle alleged False Claims Act violations
The District of Columbia reached a settlement agreement with Children’s Hospital, Children’s National Medical Center Inc. and its affiliates (collectively, “CNMC”) on June 15, 2015, to resolve allegations that CNMC violated the False Claims Act by submitting false cost reports and other applications to the U.S. Department of Health & Human Services (“HHS”) as well as to the Virginia and District of Columbia Medicaid programs. Further details can be found in the Department of Justice’s press release announcing the settlement.
Physician compensation caution
The U.S. Department of Health & Human Services Office of Inspector General (OIG) issued a special fraud alert on June 9, 2015, stating that physician compensation arrangements may result in significant liability. Hopefully this is not a surprise to any physician or entity that treats federal health plan beneficiaries. However, given that, historically, OIG regulatory actions largely (although not exclusively) focused on the entity from which a physician received compensation, such as hospitals, laboratories, durable medical equipment suppliers, pharmacies, etc., the June 9, 2015, fraud alert highlights the potential for physician liability in these arrangements.
Texas hangs up on telephone prescribers
New Texas Medical Board (TMB) rules effective June 3, 2015, limit the ability to prescribe drugs based only on telephonic consults. The rules also raise questions about the viability of some call-coverage arrangements. Specifically, for a physician prescribing medication, Tex. Admin. Code tit. 22 §190.8 now requires, among other things, a “defined physician-patient relationship” that must include a physical examination performed by the provider face-to-face or in accordance with Tex. Admin. Code tit. 22 ch. 170 rules for telemedicine. Significantly, the limitations do not apply to mental health services, except in cases of behavioral emergencies.
Missouri tort reform reformed again: medical malpractice damage caps reinstated
On May 7, 2015, Governor Jay Nixon signed Senate Bill 239 into law and reinstated damage caps for Missouri medical malpractice cases. While Missouri law previously limited damages in wrongful death actions, healthcare providers faced limitless verdicts in all other medical malpractice lawsuits. Not anymore.
Under the new law, plaintiffs cannot recover more than $400,000 for non-economic damages in medical malpractice actions. If the case involves claims of catastrophic personal injury or wrongful death, the cap is increased to $700,000. The term “catastrophic personal injury” is defined by statute to include cases of quadriplegia, paraplegia, loss of 2 or more limbs, brain injuries involving permanent cognitive impairment, irreversible major organ failure, or severe vision loss.
Value-based payments are heading for physicians
In a 92-8 vote on April 14, 2015, the Senate passed a bipartisan measure to repeal the Medicare payment formula known as the Sustainable Growth Rate (“SGR”). The legislation also included a new payment system that rewards providers for the quality and efficiency of care they provide.
Data Security for Employer Health Plans Post-Anthem
The Anthem breach sent alarm waves through the health care industry and the employer health plan community. With 78.8 million affected individuals for Anthem and 11 million for the companion breach of Premera Blue Cross, the combined size ranks among the largest data breaches in history.
The Anthem and Premera breaches signal a sea change in the threat environment for health plans, a new reality that requires a fresh look at data security. Prudent employers with group health plans should take that fresh look now, by strengthening the data security provisions in their business associate agreements (BAAs) with third-party plan administrators, and also by updating their HIPAA-required security risk assessments.
Grady Health System to pay over $2.9 million to settle claims of alleged inflated Medicaid NICU billing
The state of Georgia reached a civil settlement agreement on April 23, 2015, with Grady Health System based on allegations that Grady incorrectly coded claims for neonatal intensive care unit (NICU) patients, resulting in overpayments by Georgia Medicaid. For more details, read the Georgia Attorney General’s press release announcing the settlement.
Briefing explores legal aspects of marijuana applications in pediatric healthcare
Husch Blackwell Partner Winn Halverhout authored a briefing on the emerging use of medical marijuana in pediatric healthcare for the American Health Lawyers Association. The briefing, titled “Legal Aspects of Marijuana Applications in Pediatric Health Care,” addresses the development of state laws and cultural acceptance of marijuana.