New Funding Legislation’s Impact on Health Care Programs

Congress passed a funding bill early this morning just after the February 8th deadline. The new legislation will make several changes to the Medicare program, delay cuts to disproportionate share hospitals, provide two years of funding for community health centers, and renew certain expired or expiring health care programs. The legislation increases government funding caps by about $300 billion over two years, extends government funding through March 23rd, and provides for a one year suspension on the debt ceiling.

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DOJ Issues New Memo Limiting Use of Agency Guidance Documents in Civil Enforcement Cases: What It Means for Health Care Enforcement

On January 25, 2018, the U.S. Department of Justice (DOJ) issued a memorandum limiting the use of agency guidance documents in affirmative civil enforcement (ACE) cases.  Stating that “[g]uidance documents cannot create binding requirements that do not already exist by statute or regulation,” the memorandum strongly discourages DOJ litigators from using noncompliance with agency guidance documents as a basis for suit or as evidentiary proof in ongoing litigation.

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Leaked DOJ Memo Indicates New Government Focus on Dismissing Meritless False Claims Act Cases

Granston Memo

In a January 10, 2018 memo that leaked last week (the “Granston Memo”), the U.S. Department of Justice (DOJ) directs its prosecutors to more seriously consider dismissing meritless False Claims Act (FCA) cases brought by whistleblowers.  We have long argued DOJ dismissal is an underused tool provided by the FCA.  SeeDismissing FCA Cases Over Relators’ Objections,” Law360 (May 7, 2012).  While we expect prosecutors will remain resistant to aggressively dismissing cases, the  Granston Memo provides useful guideposts defense counsel should use to argue dismissal of defective cases – thereby saving clients significant costs and distractions in defending meritless lawsuits.

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Ten Things To Know About Maryland’s Proposed Telehealth Rules

medicare telehealth

The Maryland Board of Physicians evaluated, then tabled for further consideration, a set of new telehealth rules designed to expand the opportunities for hospitals and providers to deliver virtual care services in Baltimore and throughout the State.  The Board held a public hearing on January 24, 2018 to review proposed telehealth rules originally issued late last year. The new rules were influenced by the Washington, DC telemedicine rules, and incorporate comments submitted by a number of telehealth industry advocates, including the successful efforts of the folks at the Maryland Telehealth Alliance.

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CMS Announces an Advanced Alternative Payment Model - BPCI Advanced

On January 9, 2018, The Centers for Medicare & Medicaid Services (CMS) announced a new voluntary bundled payment model program – Bundled Payment for Care Improvement Advanced (BPCI Advanced). The episode payment model, which is a second generation version of the BPCI program, will qualify as an Advanced Alternative Payment Model (APM) under the Quality Payment Program adopted as part of MACRA, which means that physicians, because they take on financial risk, may earn the Advanced APM incentive payments.

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