Legal & Regulatory Issues

Last week, CMS issued a proposed rule to further outline provisions in the Patient Protection and Affordable Care Act that deal with health plan risk provisions.

CMS and Congress may eliminate the administrative law judge level for appeals of Medicare claims reviews, and that measure could have a major impact on hospitals and other providers, according to a recent blog post by Karen Bowden, senior vice…

The Government Accountability Office has found national Medicaid expenditures in two government databases, the Medicaid Statistical Information System and CMS-64, do not match up for fiscal years 2007 through 2009.

The following hospital lawsuits, settlements or legal developments were reported within the past month, beginning with the most recent.

Two Alabama lawmakers have asked the state's attorney general to investigate indigent care funds at county-owned Cooper Green Mercy Hospital in Birmingham, according to a Birmingham News report.

Rockledge, Fla.-based Health First has settled a seven-year-old antitrust lawsuit with Space Coast Health Foundation, according to a Florida Today report.

Two uninsured patients have sued Swedish Covenant Hospital in Chicago, alleging the non-profit hospital failed to provide charity care, according to a Chicago Tribune/Associated Press report.

Ontario, Calif.-based Prime Healthcare Services was fined $95,000 after state officials found evidence of patient confidentiality violations at Shasta Regional Medical Center in Redding, Calif., according to a Los Angeles Times Report.

Many Wyoming hospitals are opposed to a potential legislative effort that would require hospitals to post more of their prices and quality measures online, according to a Wyoming News report.

The American Society of Anesthesiologists, along with senior officials from the FDA, will be hosting a telephone town hall meeting to talk about drug shortages, according to the ASA.