November 15, 2019 Legislation




CMS revealed new changes to the Stark law that they are proposing to modernizing it.  They want exceptions for value based arrangements along with allowing cybersecurity tech to be able to be donated by hospitals to referring physicians in either a fee for service or a value based payment system.  

CMS is planning to go ahead with the site neutral off-campus hospital departments in spite of a judge's decision to void it.  The judge's decision was for the 2019 and CMS is going forward in 2020.

CMS is also going ahead with decreasing the amount it pays for part B drugs under the 340B program.  It is intending to pay the average sales prices less 22.5% instead of ASP minus 6%.  This too had been challenged in court and won by the AHA but is up on appeal.  

CMS has said that it is reducing the supervision required in hospital outpatient therapeutic services from direct tot general.  This means overall direction is needed and not presence.  It can be by phone or other electronic device.  It expects the hospitals to set supervision levels in their bylaws and policies.        Top


The California AG has continued the past AG's bad work in stymieing hospital mergers.  The AG states that the merger between Adventist Health System/ West and St. Joseph Health System to run nine hospitals in California would increase costs and decrease availability of services.  Certain advocacy groups did not want the merger due to the religious directives of the Catholic church.  Last year the AG approved a merger between two Catholich based systmes CHI and Dignity.  This was also opposed by the same groups for the same reasons.

UPMC acquired two for profit hospitals and attempted to switch them to non-profit.  the taxing autorities denied their request and the hospitals will have to continue to pay taxes for now.

OCR has fined the Texas HHS $1.6 million for their negligent placing on the internet the PMI of over 6000 people and had failed to conduct any risk analysis.

Detroit Hospital has lost its accreditation for a neurosurgery residency with Wayne State University.  The ACGME has withdrawn its OK but the reason is probably the defection of Wayne University's University Physician Group.   Detroit says Wayne still has a teaching contract and Wayne State says they have noting to do with the program.  After the ACGME decision was announced Detroit said it would help its 14 residents get a new position and then several days later said they will appeal and work with "academic partners".          Top


DISCLAIMER: Although this article is updated periodically, it reflects the author's point of view at the time of publication. Nothing in this article constitutes legal advice. Readers should consult with their own legal counsel before acting on any of the information presented.