Peer Review Privilege and Physician Employment: Balancing Competing Concerns

Medical staff peer review processes and hospital human resources practices are often addressed in separate spheres, even when a physician is both a medical staff member and an employee of the hospital. A federal district court recently held that the Colorado statutory privileges that protect the confidentiality of …

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OIG Issues Advisory Opinion Concerning Joint Ventures

The old French proverb “the more things change, the more they stay the same” comes to mind as one reads the HHS Office of the Inspector General’s most recent statements about joint ventures between heath care providers.  On September 8, 2010, the OIG issued an Advisory Opinion concerning a joint venture …

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IRS Guidance on Reimbursement of Over-the-Counter Drugs

Last Friday, the IRS issued Notice 2010-59, which provides guidance on Section 9003 of the Patient Protection and Affordable Care Act, which, effective January 1, 2011, limits the reimbursement of over-the-counter drugs under health FSAs, HRAs, HSAs, and Archer MSAs to only prescribed drugs or insulin. The Notice …

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Just Released: HHS Application Procedure for Annual Dollar Limit Waivers

In an earlier post, we discussed the interim final regulations issued relating to the prohibition of annual dollar limits on essential health benefits. Those regulations also provided that these restricted annual limits could be waived by the Secretary of HHS if compliance with the regulations would result in a …

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CMS Issues Stricter DMEPOS Supplier Qualifications

On Friday, August 27, 2010, the Centers for Medicare & Medicaid Services (CMS) issued new regulations (75 Fed. Reg. 52629) that make qualifying for and retaining Medicare billing privileges more stringent for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) suppliers. The new …

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Approved Early Retiree Applications

If you submitted an application for the Early Retiree Reimbursement Program, you may have recently received notice of your approval from HHS. If you didn’t receive an approval notice and want to see if your plan, or any other plan, has been approved, HHS released the list of the first 2,000 approved applications …

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