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By Jeffrey Herman on December 16, 2021 at 11:15 AM

In 2019, the Centers for Medicare and Medicaid Services (CMS) issued draft guidance on hospital co-location (when hospitals share space and resources with other health care entities). We previously summarized that draft guidance here. On November 12, 2021, CMS issued its final guidance and — surprise! — it changed quite a bit.

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By Jeffrey Herman on December 6, 2021 at 10:15 AM

As originally drafted, the Illinois Freedom to Work Act (IFWA) only barred employers from entering into non-compete agreements with “low wage employees,” i.e., those making no more than minimum wage or $13 per hour, whichever is greater. In 2022, the law is expanding to include broader limitations on non-competes and, for the first time, non-solicitation agreements.

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By Jeffrey Herman on March 17, 2020 at 4:00 PM

Emergency signAs the virus continues to spread, U.S. hospitals will likely see increasing numbers of potential cases of COVID-19 in their emergency departments. Hospitals are obligated under the Emergency Medical Treatment and Labor Act (EMTALA) to provide these individuals with certain examinations and, if necessary, stabilizing treatment or transfer. This raises a host of issues for hospitals that receive these individuals for care, including capacity and resource concerns, and the risks these individuals may pose to medical personnel and other people in the vicinity, including other patients and staff.

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By Jeffrey Herman on October 31, 2019 at 11:10 AM

Image of medical professionalAs of Nov. 1, 2019, hospitals — as well as other types of health care providers — submitting claims to Missouri or Illinois Medicaid programs will be subject to a new restrictive rule concerning ordering, referring and prescribing providers (ORP). The ORP rule may result in hospitals unexpectedly having some Medicaid claims denied. Below is a description of the rule, some differences between Missouri and Illinois, where the rule comes from, and what claims it applies to.

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By Jeffrey Herman on June 7, 2019 at 11:15 AM

"HIPAA" shown on a tabletThe Office of Civil Rights (OCR) within the Department of Health and Human Services (HHS) has been able to hold “business associates” directly liable for certain HIPAA violations since 2009, with the passage of the Health Information Technology for Economic and Clinical Health (HITECH) Act. Under HIPAA, a “business associate” is an entity that receives protected health information (PHI) in order to provide services to a “covered entity” (such as a health care provider, a health plan, or a heath care clearinghouse).

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By Jeffrey Herman, Gregg Lepper on May 9, 2019 at 11:30 AM

Hospital interiorMany hospitals share space with other health care entities. Despite this, the Centers for Medicare & Medicaid Services (CMS) has given mixed signals — and never issued formal guidance — concerning the permissibility of shared spaces under the Medicare Conditions of Participation (CoP). This has created great confusion and uncertainty for hospitals as they try to meet the challenges of a rapidly changing health care system.

That’s all about to change!

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By Jeffrey Herman on April 4, 2019 at 2:45 PM

Envelope with a stamp that says, "Return to Sender"The Centers for Medicare & Medicaid Services (CMS) has found that hospitals are increasingly operating “off-campus, outpatient, provider-based” departments. Services provided at these off-campus facilities are required to be billed using the off-campus facility’s address so that payment can be accurately made under the Medicare Physician Fee Schedule (MPFS) or the Outpatient Prospective Payment System (OPPS).

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By Jeffrey Herman on April 2, 2019 at 2:20 PM

The battle over health benefits rages on. In the latest salvo, a group of states scored a major court victory against the Trump administration’s new “Association Health Plan” Final Rule, which was finalized in 2018. While this decision will have major ramifications, it is important to remember that association health plans may still be established under old rules that existed long before the final rule.

The case is styled New York v. United States Dep’t of Labor, No. CV 18-1747 (JDB), 2019 WL 1410370 (D.D.C. Mar. 28, 2019).

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