Showing 80 posts in Hospitals.
Hospital Mergers Continued to Climb in 2014
Since the approval of the Affordable Care Act in 2010, hospital consolidation has been on the rise and according to a report detailed in a recent Chicago Tribune article, 2014 followed suit with a “flurry of mergers, acquisitions and joint ventures.” The article features findings from a report issued by healthcare consulting firm Kaufman Hall, including that in 2014 95 deals were announced, down slightly from 98 in 2013 but up from 66 in 2010.
Passage of the Affordable Care Act (ACA) in 2010 increased pressure on hospitals to operate more effectively and efficiently, which has driven industry consolidation. The ACA favors a service model that rewards organizations for producing quality outcomes – not quantity – and many providers believe that compliance will be easier with the greater scale and integration enabled by mergers. Through consolidation, many also hope to be better positioned to attract new patients with expanded services and medical specializations.
Additionally, the ACA’s introduction of a massive wave of new patients into the healthcare system, combined with diminishing Medicaid and Medicare reimbursements, means that the business of healthcare is becoming increasingly expensive, especially for independent hospitals. Another challenge – and driving force behind consolidation – has been the need to upgrade IT systems and facilities to comply with rules and regulations beyond the ACA. Read More ›
Categories: Health Care Reform, HIPAA, HITECH Act, Hospitals, News & Events
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And Then There Was One: Economic Pressures Squeeze Metro Detroit Hospitals into Consolidation
Reduced reimbursements. A shift toward global payment. A demand for integration, quality of care and medical specializations. In order to compete amidst today’s healthcare market pressures, independent hospitals in Michigan and around the nation are increasingly deciding that they cannot go it alone. A recent Detroit News article reveals how this trend is playing out in Metro Detroit, with one of the region’s last two independent hospitals poised for acquisition.
Observers of Detroit’s healthcare environment are reportedly not surprised by the news that Crittenton Hospital Medical Center has signed a letter of intent to join St. Louis-based Ascension Health, the largest Catholic and nonprofit health system in the nation. With Monroe-based Mercy Memorial Hospital announcing on January 6 that it is joining the ProMedica health care company, the Crittenton deal will leave Doctors’ Hospital in Pontiac as the region’s last remaining independent hospital.
Laura Wotruba, spokeswoman for the Michigan Health and Hospital Association, said that this is not a Michigan issue, but rather a widespread pattern. “[It is] a national trend [and] something we’ve been seeing around the country.” Read More ›
Categories: Electronic Health Records, Health Care Reform, HIPAA, HITECH Act, Hospitals, News & Events, Regulatory
"Right to Try" Becomes a Reality in Michigan
On Friday, October 17, Governor Rick Snyder signed the Right to Try Act, which allows patients to try experimental drugs and other treatments before they have been approved by the Food and Drug Administration (FDA). The law gives patients with advanced illnesses access to drugs that successfully cleared Phase 1 of an FDA approval. Phase 1 testing seeks to establish a drug's safety and profile and evaluates possible side effects. It involves 20-80 volunteers and lasts approximately one year. Read More ›
Categories: Hospitals, Insurance, Physicians, Providers
Hackers Declare War on Health Care and Industry Fights Back
"It's a war we're in." That's how John Halamka, the chief information officer of Boston-based Beth Israel Deaconess Medical Center, described the current state of affairs between the health care industry and the hackers and identity thieves who are trying to steal patient records.
A recent Boston Globe article detailed the threat and provided some interesting - and sobering - statistics and information:
- There is high demand for health records, and a single health record may be worth $50 according to the FBI
- Criminal intrusions into health care systems have risen 100 percent in the past four years
- Of 614 total identity theft breaches in 2013, 269 (43.8 percent) were in health care (the most of any industry)
- Despite being the subject of the most attacks, a recent study by BitSight Technologies found that health care providers are the slowest in any industry to respond to data breaches.
Hackers are motivated to target health records in order to facilitate identity theft, financial fraud and illegal drug use. The Boston Globe article, in particular, highlighted two recent incidents involving cyber-security breaches: (1) Chinese hackers seized the personal information of 4.5 million patients at a Tennessee-based hospital network, and (2) federal officials disclosed on September 4 that a hacker managed to install malicious software on HealthCare.gov. Read More ›
Categories: Electronic Health Records, Hospitals, Privacy, Providers
New requirements for tax exempt hospitals imposed by the Affordable Care Act
The Affordable Care Act, enacted on
March 23, 2010, has established a number of new requirements that nonprofit
hospitals must meet to maintain tax exemptions. Some of these new obligations,
all codified in Section
501(r) of the Internal Revenue Code, include community health needs
assessment and implementation, financial assistance and emergency care policies,
limits on charges, and billing and collection restrictions.
In June 2012, the IRS released proposed regulations offering guidance to tax-exempt hospitals relating to certain provisions of Section 501(r). Although, the proposed regulations do not have the force of law, hospitals may rely on these to assist in implementing the requirements.
Below is a brief summary that highlights some of the new requirements for tax-exempt hospitals. Please refer to the full rule, Section 501(r) or contact us, to explore the extent of the new requirements in more detail.
Community health needs assessment and implementation (CHNA)
Effective for tax years beginning after March 23, 2012, hospital facilities must conduct a CHNA and adopt an implementation strategy at least once every three years. Read More ›
Categories: Health Care Reform, Hospitals
CMS Finalizes Changes to Unnecessary, Obsolete, Counterproductive or Excessively Burdensome Regulations
On May 7, 2014, the Centers for Medicare and Medicaid Services (“CMS”) issued a Final Rule to reform Medicare regulations identified as “unnecessary, obsolete, counterproductive or excessively burdensome” to hospitals and other health care providers. The changes are part of the Obama administration’s “regulatory lookback” in connection with Executive Order 13563, “Improving Regulation and Regulatory Review.” The Final Rule makes a number of clarifications and revisions to policies set forth in both the May 16, 2012 final rule and the February 7, 2013, proposed rule. CMS estimates the reforms could save providers nearly $660 million annually and $3.2 billion over five years.
Below is a brief summary that highlights some of the issues CMS is attempting to address. Please refer to the Final Rule, or contact us, to explore the full extent of the changes in more detail. Read More ›
Categories: Compliance, Hospitals, Medicare/Medicaid, Providers, Regulatory
Cyberattacks on Hospitals – A Growing Epidemic
As hospitals and doctors across the country become more technologically sophisticated and use more and more medical devices that are connected to the Internet in some fashion, they are increasingly being attacked and compromised by sophisticated cyberattacks. Attacks on US hospitals’ medical data – which put patient records and personal information at risk – have more than doubled since 2010, according to a new study by the Ponemon Institute.
In its report, the Ponemon Institute states that 90 percent of health care institution respondents had at least one data breach in the last two years, while 38 percent had more than five data breaches during that same time period. While many of these breaches stemmed from lost or stolen computers, technical glitches, and third-party problems, several were due to criminal attacks. Read More ›
Categories: Criminal, Electronic Health Records, Hospitals, Privacy
New Laws Expand Powers and Responsibilities of Guardians Relating to DNR Orders
On Feb. 4, 2014, new legislation took effect amending Michigan's Do-Not-Resuscitate Procedure Act (the "Act").The Act allows a guardian, who has the power under Michigan’s guardianship laws, to consent to a do-not-resuscitate order (“DNR Order”) on behalf of a legally incapacitated person under certain conditions. This power does not extend to a guardian ad litem.
In 1996, Michigan passed the Act, which permits a competent adult or his or her patient advocate to sign a DNR Order instructing emergency personnel not to perform potentially life-saving procedures in the event of the cessation of respiration and circulation. However, the Act did not give express authority to a guardian acting on behalf of an individual to authorize a DNR Order. Read More ›
Categories: Compliance, Hospitals
NPDB Guide for Reporting Clinical Privileges Actions
The National Practitioner Data Bank (NPDB) has published a quick guide to assist hospitals and health care entities in reporting actions that adversely affect clinical privileges held by physicians, dentists and other health professionals.
The guide (We have identified that the following link is no longer active, and it has been removed) lists several “reporting scenarios” and indicates the type of report that may be required (initial adverse action report, revision-to-action report, correction report, or no report). The guide also summarizes the reasons for voiding a previous report (report was erroneously submitted, action was not reportable, or action was reversed or overturned).
The guide is a helpful starting point for a hospital or health care entity that is involved in a privileging action. However, the scope and timing of reporting requirements under the NPDB regulations can be quite complex. Considering the very serious implications from reporting—or not reporting—an adverse privileging action, it would be prudent to only use the guide as a quick reference and not as a decision-making tool.
If you have any questions about the guide, please contact Richard Kraus at 517.371.8104 or by using the email form below.
Categories: Hospitals, Physicians
Health Care Providers Face Steep Penalties for Medicare/Medicaid Fraud
So far, July has been a busy month for health care fraud enforcement across the country.
On July 18, Divyesh Patel, owner of Alpine Nursing Care Inc. in North Randall, Ohio, was sentenced to two years in prison after pleading guilty to one count of conspiracy to commit health care fraud and four counts of health care fraud. Patel was also ordered to pay total restitution of $1,939,864 to the Medicaid Program in Ohio. According to court documents, Patel hired Belita Mable Bush as the office manager despite knowing that Bush had been convicted of a health care-related felony and excluded from involvement in billing federal health care programs. From June 1, 2006 to October 18, 2009, Patel conspired with Bush to defraud Medicaid by billing for services that had never been performed or that had been performed by excluded individuals. The conspiracy resulted in losses of approximately $1.9 million to the Medicare and Medicaid programs. Bush was convicted on similar charges and will be sentenced next month. Read about more cases ›
Categories: Fraud & Abuse, Health Care Reform, Hospitals, Medicare/Medicaid, Physicians
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Best Lawyers® 2021
Congratulations to the attorneys of the Health Care practice group at Foster Swift Collins & Smith, PC for their inclusion in the Best Lawyers in America 2021 edition. Firm-wide, 44 lawyers were listed. Best Lawyers lists are compiled based on an exhaustive peer-review evaluation and as lawyers are not required or allowed to pay a fee to be listed; inclusion in Best Lawyers is considered a singular honor. Health Care practice group members listed in Best Lawyers are as follows:
- Jennifer B. Van Regenmorter, Holland
To see the full list of Foster Swift attorneys listed in Best Lawyers 2021, click here.