Author Archives: Kurt Bratten
Health Planning Committee of the Public Health and Health Planning Council Proposes Significant Certificate of Need Redesign
The Health Planning Committee of the Public Health and Health Planning Council is proposing a significant Certificate of Need (“CON”) redesign. The Committee and Council are expected to make twenty-two (22) recommendations to the Department of Health next week, affecting … Continue reading
CMS Issues Section 1135 Waivers for New York and New Jersey
The Centers for Medicare and Medicaid Services (CMS) approved waivers for New York and New Jersey under Section 1135 of the Social Security Act. The waivers ease certain legal requirements on healthcare providers who are serving those impacted by Sandy. … Continue reading
New York State Allegedly Overbilled $15 Billion for State-Operated Facilities for Developmentally Disabled
On May 17, 2012, the U.S. Department of Health and Human Services, Office of Inspector General (OIG) released a report that found Medicaid overpayments to New York State-operated developmental centers. The OIG concluded that, in 2009, State-operated facilities for the developmentally disabled … Continue reading
Ninth Circuit Court Rules Recovery Audit Contractor’s Decisions to Reopen Medicare Claims For Good Cause Can’t Be Challenged
Two weeks ago the U.S. 9th Circuit Court of Appeals ruled in Palomar Medical Center v. Sebelius that a health care provider is not entitled to challenge the determination of a Medicaid Recovery Audit Contractor (“RAC”) to reopen a Medicare claim … Continue reading
OMIG Releases Compliance Alert for Medicaid Providers
The New York State Office of Medicaid Inspector General (“OMIG”) recently released a Compliance Alert that explains what types of Medicaid providers are required to have a compliance program and what steps those providers can take to ensure that they … Continue reading
Legal Hurdles Mount for Lab Corp and Quest
The U.S. Department of Justice (DOJ) and the Federal Trade Commission (FTC) recently released their Annual Report for Fiscal Year 2011 under the Hart-Scott-Rodino Antitrust Act. In brief, the Hart-Scott-Rodino Act allows the DOJ and FTC to block transactions believed to be … Continue reading
Department of Justice & HHS Announce Record Recoveries in 2011
On February 14, 2012, the Department of Health and Human Services (HHS) and the Department of Justice (DOJ) published a Report (a copy of which can be found here) touting recoveries of “[a]pproximately $4.1 billion stolen or otherwise improperly obtained … Continue reading
Cuomo Signs Executive Order Limiting Spending for Administrative Costs and Executive Compensation at State-Funded Service Providers
This week Governor Andrew M. Cuomo signed Executive Order No. 38 which limits how much state funded service providers can compensate their executives. In his address prior to issuing the Order, Governor Cuomo said that “[r]oughly one-third of the budget … Continue reading
CMS Publishes Regulations on Accountable Care Organizations
Today, CMS published its final rule implementing the part of the Affordable Care Act governing Accountable Care Organizations (ACOs). A copy of the rule is available here. The portion of the Affordable Care Act implemented under this new rule requires … Continue reading
HHS Proposes Rule Giving Patients Direct Access to Lab Test Results
Yesterday, the U.S. Department of Health and Human Services (“HHS”) published a proposed rule in the Federal Register which would allow medical patients to get their laboratory test results directly from the lab. A copy of this proposed rule is … Continue reading
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