Hospitals

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Recent changes in federal immigration enforcement practices have prompted renewed attention to how healthcare providers manage requests from law enforcement agencies. While federal policy continues to recognize healthcare facilities as sensitive environments, there has been increased interest in enforcement activity in or around such locations. Healthcare organizations should consider taking this opportunity to review internal protocols and confirm they are prepared to respond in a manner that is consistent with applicable federal and state law.Continue Reading Immigration Enforcement and Healthcare Facilities: Key Considerations for Providers

Hospitals charge a standard evaluation and management services fee (“EMS”) for patients seen in the emergency room, in one of five amounts, depending upon the severity of the visit. This EMS fee is listed in the hospital’s public “chargemaster,” a comprehensive price list required by law. But does the hospital also have a duty to inform individual ER patients, before they receive services, about the EMS fee?Continue Reading California Supreme Court Rejects Non-Disclosure Theory for ER Evaluation and Management Fees, Holding that Hospitals owe no Additional Duty Outside Regulatory Pricing Disclosure Regime

Cyberattacks on healthcare organizations are on the rise, with the number of affected individuals nearly tripling between 2022 and 2024, according to data compiled by the Department of Health and Human Services Office for Civil Rights (“OCR”).[1] OCR data also reveals a 239% and 278% increase in hacking incidents and ransomware attacks, respectively, between January 2018 and September 2023.Continue Reading New York Adopts Comprehensive Hospital Cybersecurity Requirements

Where Physician Burnout and Value-Based Care Intersect

This series explores legal issues related to physician burnout and potential solutions, and here we explore the potential impact of value-based care (“VBC”). Our first post addressed how healthcare organizations can foster the psychological safety and emotional well-being of their physicians. Our second post discussed artificial intelligence solutions as a potential way to attract, support and retain overwhelmed clinicians. Here, we explore how VBC can promote physician satisfaction and physician wellness by:Continue Reading Healing the Healers: Using Value-Based Care Strategies to Mitigate Physician Burnout

The IRS is underway with conducting audits of 35 Section 501(c)(3) tax-exempt hospitals, with a particular focus on “community benefit,” as the IRS announced in June 2024. Targeted hospitals appear to be those who reported low community benefit percentages on their IRS Form 990.Continue Reading IRS Audits & Ongoing Scrutiny of Nonprofit Hospitals – Key Background & Action Steps

On June 10, 2024, the U.S. Supreme Court granted certiorari in Advocate Christ Medical Center v. Becerra[1] for the October 2024 – 2025 term to review a D.C. Circuit Court of Appeals ruling potentially affecting up to $4 billion in federal funding for hospitals.[2] The Supreme Court will determine whether the federal Department of Health and Human Services (“HHS”) properly reimbursed hospitals for providing care to patients receiving financial aid from the Supplemental Security Income Program (the “SSI Program”).[3] Hospitals benefiting from Medicare reimbursement adjustments for treating low-income patients should closely monitor this case, as a favorable ruling for the plaintiffs may impact how hospitals are reimbursed for similar claims in the future.Continue Reading SCOTUS to Review Case Impacting Medicare Reimbursement for Hospitals Treating Low-Income Patients

On May 16, 2024, the Subcommittee on Health of the House Committee on Energy and Commerce (the “Subcommittee”) announced that it advanced the Telehealth Modernization Act of 2024 (H.R. 7623) as amended (the “Bill”) during a markup session. The Bill is meant to extend a number of telehealth flexibilities under Medicare through 2026. This corresponded with 22 other bills advanced by the Subcommittee to strengthen access to healthcare.Continue Reading Congress Seeks to Extend COVID-19 Telehealth Flexibilities Through 2026 and Expand Reimbursement

Effective October 20, 2024, New York hospitals must have in place State-mandated changes to their financial assistance (“FA”) programs (including FA eligibility criteria and debt collection practices) and their practices related to consent forms, and patient use of credit cards and medical financial products. The new requirements were enacted as part of the State’s health and mental hygiene budget legislation for fiscal year 2024 through 2025, signed into law by Governor Hochul on April 20, 2024. The legislation expands financial assistance eligibility to a wider range of patients and implements greater patient protections related to medical debt collection practices.Continue Reading New York Broadly Revises Hospital Financial Assistance, Medical Debt Collection and Related Requirements

At HLTH 2023, we saw a focus on certain themes, including the shift in investments and M&A activity, hospital and health system innovation and transformation, the implementation of AI, and healthcare management. Below are our top 10 takeaways from what we heard, and did not hear, at HLTH 2023.Continue Reading Sheppard Mullin’s Top 10 Takeaways from HLTH 2023

What is New:

Department of Health Care Access and Information (“HCAI”) posted a draft methodology for evaluating applications for the Distressed Hospital Loan Program (“Loan Program”) and is surveying California hospitals to assess interest in the Loan Program. Continue Reading Update to: A Lifeline Amidst Turbulent Times: California Lawmakers Approve Emergency Loans for Struggling Hospitals

On April 26, 2023, the Centers for Medicare and Medicaid Services (“CMS”) released a fact sheet on Hospital Price Transparency Enforcement Updates[1] (the “Fact Sheet”) under the Hospital Price Transparency Rule (the “Rule”).[2] CMS’ updates were targeted at increasing compliance by hospitals with the Rule and providing a more streamlined enforcement process for violations of the Rule.Continue Reading CMS Releases Updates to Hospital Pricing Transparency Rule