Earlier this month, the United States Department of Justice (“DOJ”) filed a suit against Vitas Hospice Services, L.L.C. and its subsidiary entities (“Vitas”) alleging that Vitas submitted false claims for hospice services which were excessive, unnecessary, or not provided, and also alleging that Vitas admitted patients to hospice who were not terminally ill ...
The Federal Trade Commission’s increased focus on the antitrust implications of healthcare mergers and acquisitions has been widely publicized. While scrutiny has largely been directed toward hospital and health system transactions, a recent case in Nevada indicates that the FTC is now taking an interest in relatively small provider combinations in highly concentrated markets ...
In what seems a long time past, yet was actually only three weeks ago, Congress enacted theFamilies First Coronavirus Response Act (FFCRA) that includes Emergency Family and Medical Expansion Act and The Emergency Family and Medical Leave Expansion Act. The legislation, largely administered by the Department of Labor, provides payroll tax credits to employers in order to ease the burden of new provisions requiring certain paid leave for employees due to COVID-19 ...
After two years of review, the Office of the Comptroller of the Currency (OCC) recently announced that it will begin accepting applications for special purpose national bank charters from financial technology (fintech) companies. The OCC’s announcement came hours after the Treasury Department endorsed the approach ...
Just over one year ago, new ATM regulations under the Americans with Disabilities Act (ADA) became enforceable. Since virtually the stroke of midnight on March 15, 2012, banks, credit unions and other ATM operators have been served with lawsuits alleging noncompliance with certain of those new ADA regulations, particularly those requiring auxiliary aids and services for ATM users who are blind or have low vision ...
Don Stuart, a partner in Waller’s Tax Practice Group and current Chair of the Tax and Finance Practice Group of the American Health Lawyers Association (AHLA), and Kim Looney, partner in the firm’s Healthcare Compliance and Operations group, are authors on two chapters in the AHLA’s new publication The ACO Handbook: A Guide to Accountable Care Organizations, Second Edition ...
The FDIC and other banking and credit agencies provided specific guidance to FDIC-supervised financial institutions that are working with borrowers affected by COVID-19. The Interagency Statement on Loan Modifications and Reporting by Financial Institutions Working with Customers Affected by the Coronavirus, issued on March 22, encourages lenders to “work constructively with borrowers” and offers the following guidance ...
Last week, Waller kicked off its multi-part series examining the near- and medium-term impact of President-elect Biden on the financial services industry with Part I of a discussion analyzing the likely direction of financial services regulatory reform under the Biden administration. Part II continues the discussion and incorporates emerging information regarding Biden’s financial regulatory platform ...
Because of a recent decision by the Tennessee Court of Appeals, a bank may not rely as heavily on a Power of Attorney (“POA”) as much as it may have relied previously for immunity to claims brought against the bank by the Grantor of the POA. A bank may now be held liable for transactions made by the Agent, even when the POA grants broad and virtually unrestricted authority to the Agent. Until recently, there appeared to be a conflict in the Tennessee Code ...
A Business Friendly Decision from the Tennessee Supreme Court By: Woody Woodruff and Becca Brinkley In a recent opinion, the Tennessee Supreme Court ruled that a lender that extends credit to a business may, under the right circumstances, also enforce a personal guarantee against the business owner, even if the owner does not sign in his personal capacity ...
The Federal banking agencies recently issued an interim final rule (Regulatory Capital Rule: Revised Transition of the Current Expected Credit Losses Methodology for Allowances) permitting banks to mitigate the effects of the current expected credit loss, or CECL, accounting standard. Introduced in 2016 by the Financial Accounting Standards Board, CECL replaces the incurred loss methodology for financial assets and requires banks to recognize lifetime expected credit losses ...
Chapter 11 of the United States Bankruptcy Code (the “Bankruptcy Code”) is intended to give a debtor time and ability to restructure its balance sheet and business or to liquidate its assets responsibly in order to maximize recoveries of creditors. The Bankruptcy Code has the added benefit of the automatic stay, which generally prevents collection actions or actions to exercise rights and remedies against the debtor’s assets during the pendency of the bankruptcy case ...
Following up on the passage of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), the Department of Health and Human Services (HHS) recently issued a proposed rule to replace the Medicare sustainable growth rate (SGR) methodology which was repealed by MACRA. The proposed rule would implement the Merit-based Incentive Payment System (MIPS) to replace SGR and establish incentives for participation in Advanced Alternative Payment Models (Advanced APMs) ...
A number of events have occurred recently involving the Federal Trade Commission and healthcare entities. First, garnering the lead spotlight, the FTC began presenting its case in the U.S. District Court for Northern Illinois to enjoin a merger between Advocate Health and NorthShore University HealthSystem, two large Chicago-area health systems ...
The global financial crisis which began in 2008 elevated the prosecution of crimes affecting federally insured financial institutions to near the top of the Justice Department’s priority list. Directors and officers of those institutions, already under scrutiny from the regulators and law enforcement agencies traditionally charged with examining their actions (e.g ...
Most people probably associate cyber-crime with issues of national security—what with Russia dominating so much space in the headlines, lately. However, cybersecurity breaches can have a palpable and damaging effect on everyday individuals, due to how often they’re tied to corporate security breaches involving highly sensitive personal information like credit card numbers, social security numbers, and contact information ...
In August 2016, the Office of the National Coordinator for Health Information Technology (ONC) and the National Institute of Standards and Technology (NIST) co-sponsored the Use of Blockchain in Health IT and Health-related Research Ideation Challenge, soliciting whitepapers on how blockchain technology can be used in health care ...
The second HIPAA settlement of 2021 is the first traditional enforcement action of the year. And, it’s a big one. Traditionally, OCR enforcement has been triggered by breaches. In 2020, however, we saw a significant increase in a sub-set of Privacy Rule enforcement arising out of the U.S. Department of Health and Human Services’ Office for Civil Rights’ (OCR) patient “Right of Access” initiative ...
On July 7, 2016, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule intended to prohibit hospitals operating certain off-campus provider-based departments (PBDs) from billing under the Outpatient Prospective Payment System (OPPS). In an effort to implement Section 603 of the Bipartisan Budget Act of 2015, CMS says the proposed rule will save about $500 million a year by refocusing payments on the patient rather than the clinical setting ...
The financial exploitation of elders is a hot topic in state legislatures, with the federal government, and in the media. In the first few months of 2017 alone, media reports from Gadsden, Fairhope and Dothan chronicle four cases of financial exploitation, with losses in each case ranging from $20,000 to $100,000 over short periods of time. The perpetrator in each case was a family member of the victim ...
Many governmental authorities across the country have ordered “nonessential” businesses to shut down because of the COVID-19 crisis. Many business owners are asking what that means for the business income losses that they are forced to endure and whether insurance will cover those losses. Most property insurance policies that offer business interruption coverage provide some form of “civil authority” coverage ...
Two schools of thought have emerged on business interruption insurance coverage for coronavirus, either (a) it is a total panacea that will shift the risk of coronavirus revenue losses to insurance carriers or (b) there is no possible coverage for losses caused by coronavirus. As with most things in life and insurance, the truth lies somewhere in between and will depend on the specific policy at issue and the jurisdiction interpreting the policy ...
Last month, CMS issued a proposed rule that would drastically expand the agency’s authority to further its program integrity efforts through the provider and supplier enrollment process. This proposed rule, referred to as CMS-6058-P, (located in the Federal Register at 81 Fed. Reg. 40 ...
