Health Law Monitor

Health Reform Update - Provider Impact

Health Reform Update

 The third installment of our health reform series focuses on the impact upon health care providers of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Affordability Reconciliation Act (referred to together herein as “PPACA”).

Health Reform Whitepaper: Employer Impact of PPACA

Health Reform Whitepaper: Employer Impact of PPACA 

The second installment of our Health Reform series focuses upon the impact of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Affordability Reconciliation Act (referred to together herein as “PPACA”) upon employers and their group health plans. PPACA places a number of requirements upon both existing and new group health plans (including both insured and self-insured plans) that will take effect for plan years beginning on or after September 23, 2010. Hence, for calendar year plans, many of the changes must be in place by January 1, 2011. PPACA also establishes certain employer health insurance play-or-pay mandates commencing in 2014.  

Health Care Reform Whitepaper: New IRS Mandates for Charitable Hospitals

 

    Under prior law, charitable hospitals established tax-exemption under Internal Revenue Code (“IRC”) § 501(c)(3) by providing a community benefit. Most hospitals established a community benefit by providing health care regardless of a patient’s ability to pay (including payment through Medicare or Medicaid), by providing charitable (unreimbursed) care to the community, by maintaining an emergency room, by not restricting use of its facilities to a particular group of physicians, and/or by utilizing excess funds to improve the quality of patient care, expand facilities, and advance medical education and research.

Illinois Supreme Court Holds that Property Owned by Catholic § 501(c)(3) Health System not Exempt from Illinois Property Tax

On March 18, 2010, the Supreme Court of the State of Illinois decided a property tax case that could have nationwide implications for charitable healthcare organizations. A copy of the decision is available at http://www.state.il.us/court/Opinions/SupremeCourt/2010/March/107328.pdf. The Court ruled that forty-three parcels of real estate owned by Provena Hospitals were not exempt from Illinois ad valorem property tax under either the charitable or religious use exemptions of the Illinois code. This plurality decision of the Illinois Supreme Court is disturbing because the Court seems to have gone out of its way to define charitable use, in the context of the taxation of property owned by a non-profit IRC § 501(c)(3) hospital, so narrowly that many hospitals operating in today’s healthcare environment may not be able to maintain their exemption if the reasoning in this case is adopted by other jurisdictions, including West Virginia.

Important Changes to Medicare Secondary Payer Electronic Reporting Rules

The Centers for Medicare and Medicare Services ("CMS") announced that it is extending the date for electronic reporting under the Medicare Secondary Payer rules for all Non-Group Health Plans from April 1, 2010 to January 1, 2011.

PREPARED TO COMPLY? - HITECH ACT ENFORCEMENT SET TO BEGIN

On February 17, 2010, HHS will begin to enforce changes to the HIPAA enacted through the HITECH Act.  The new requirements imposed by the HITECH Act will have a significant impact on the privacy and security of personal health information and compliance efforts of affected healthcare Covered Entities and their Business Associates.  The HITECH Act has expanded the direct applicability of the Privacy and Security Rules to Business Associates.  Significant changes may be necessary to comply with the new requirements.  

The 'Other' Health Care Reform Moves Ahead

The federal government moves ahead with its incentive program for the adoption of electronic health records.

 

Jackson Kelly lawyer James W. Thomas recently wrote an article that explores a pair of coordinated regulations issued by the U.S. Department of Health and Human Services on Jan. 13 which will define “meaningful use” for electronic health record systems.

 

To read Thomas’ article that appeared in the Jan. 29, 2010 edition of The State Journal, click here.  

 

The State Journal is a weekly business newspaper in West Virginia.

CMS CLARIFIES SUPERVISION REQUIREMENTS FOR OUTPATIENT SERVICES

CMS recently released its 2010 Outpatient Prospective Payment System (“OPPS”) rule clarifying the requirements for supervision of certain hospital outpatient services. The rule makes clear that if direct physician supervision is required for the performance of an outpatient service, this level of supervision may not be assumed to exist in a hospital setting. Rather, a hospital must establish a plan or policy to ensure that the direct supervision required by the Centers for Medicare and Medicaid Services (“CMS”) for a particular outpatient service is available. Read More.

NEW REGULATION INCREASES PENALTIES FOR HIPAA VIOLATIONS

HHS issued its interim final rule increasing penalties for privacy and security violations under the HIPAA. The new rule significantly increases the maximum penalty for civil violations of HIPAA, and decreases the defenses available to providers. The new penalty amounts apply to HIPAA violations occurring on or after February 18, 2009.  For more information about these requirements, click here.

CMS Issues Options for Providers to Comply with EMTALA in Anticipation of H1N1

In anticipation of a possible H1N1 virus outbreak this flu season, CMS has released guidance concerning EMTALA requirements during disasters and pandemics.  CMS has outlined compliance options that are permissible under EMTALA and that grant providers with flexibility to handle extraordinary increases in emergency department visits.  The options include setting up alternative screening sites on the hospital campus, off-campus screening at hospital-controlled sites, and community screening clinics at sites not under hospital control.  To read more click here.