The Unwelcome Return of Administrative Denials

We are hearing from hospital clients that health plans are again falling back on the use of administrative/technical denials to deny or reduce payments for hospital admissions, where the hospital … Continue Reading →


HRSA Revises FQHC Forms for Identifying Services and Site

The Health Resources and Services Administration of the U.S. Department of Health and Human Services (“HRSA”) published a Program Assistance Letter on May 13, 2014, to explain revisions that were … Continue Reading →


DSRIP Medicaid Waiver Amendment Update

The New York State Department of Health (DOH) has provided a number of important updates regarding the DSRIP program. DOH has updated the lists of eligible safety net providers.  DOH … Continue Reading →


Delivery System Reform Incentive Payment (DSRIP) Program Details Still Emerging But Deadlines Already Looming

CMS has provided final approval of a Medicaid Waiver to provide over $8 billion for reforming the delivery of healthcare in New York, including the establishment of a new, comprehensive … Continue Reading →


Employers Must Engage in Good Faith Interactive Process When Employee with a Known Disability Requests an Accommodation

On March 27, 2014, the New York Court of Appeals ruled that an employer who failed to engage in a good faith interactive process before denying a disabled employee an … Continue Reading →


NLRB Strikes Down Hospital’s Policy Prohibiting Employee Negativity

On April 1, 2014, the National Labor Relations Board (NLRB) ruled that a hospital’s “Values and Standards of Behavior” policy proscribing negativity violates the National Labor Relations Act (NLRA).   The … Continue Reading →


Telemedicine Reimbursement Bills Advance in New York and Connecticut

Looking to join the 20 other states and the District of Columbia which already mandate such coverage, both the New York and Connecticut Legislatures are currently considering bills that would … Continue Reading →


County Government Settles Potential HIPAA Violations

Skagit County, Washington recently agreed to a $215,000 settlement, as well as agreeing to correct deficiencies in its HIPAA compliance program, with the Health and Human Services Office for Civil … Continue Reading →


NY Appellate Court Recognizes Private Right To Sue Under “Prompt Pay Law”

New York’s Prompt Pay Law (New York Insurance Law Section 3224-a), requires insurers to pay undisputed claims within 30 days after receipt of an electronic submission, or within 45 days … Continue Reading →


Meaningful Use Audits On the Rise

Medicare and Medicaid have increased their audits of providers who attested to “meaningful use” in order to receive payments under the Medicare and Medicaid Electronic Health Record Incentive Program (“EHR … Continue Reading →