Corporate Counsel

Latest in Corporate Counsel
  • March 6, 2017

    By Lauren Bikoff, MLS

    Projected savings targets needed to cover health care in retirement went up last year after several years of decline, but are still generally lower than they were five years ago, according to recent research from the Employee Benefit Research Institute (EBRI).

  • March 3, 2017

    By Kayla R. Bryant, J.D.

    Golden Living Center—Superior (Golden), a skilled nursing facility (SNF) in Wisconsin, did not adequately protect its residents from the spread of infection when it failed to follow three specific elements of its own protocols. The Departmental Appeals Board (DAB) affirmed an administrative law judge’s (ALJ) finding that Golden’s lack of compliance resulted in immediate jeopardy to the health and safety of residents for a period of two weeks, justifying civil money penalties (CMPs) totaling over $71,000 ( Golden Living Center—Superior v. CMS, Docket No. A-16-44, Decision No. 2768, February 3, 2017).

  • March 1, 2017

    By Ronald Miller, J.D.

    An all too familiar claim is that an employer misclassified an employee as exempt from the overtime protections of the FLSA and the corresponding state law. Employees covered by the FLSA, 29 U.S.C. § 207(a)(1), must receive overtime pay for hours worked in excess of 40 in a workweek at a rate not less than one and one-half times their regular rates of pay. However, Congress exempted employees “employed in a bona fide executive, administrative, or professional capacity” from these wage requirements, 29 U.S.C. § 213(a)(1). FLSA exemptions are construed narrowly, so the employer bears the burden of establishing entitlement to an exemption. Moreover, application of an exemption is limited to those establishments plainly and unmistakably within the exemptions’ terms and spirit.

  • February 28, 2017

    By Anthony H. Nguyen, J.D.

    A complaint alleging that Baker Donelson committed legal malpractice by providing erroneous advice to The Summit Health and Rehab Services, Inc. (Summit), namely that Summit could retroactively bill for services before it received official CMS enrollment approval, was removed to federal court for diversity reasons. The complaint was originally filed in a Mississippi circuit court, before its assignment to a federal court in Mississippi under Case No. 3:17-cv-00127-WHB-JCG.

  • February 28, 2017

    By Bryant Storm, J.D.

    Self-referral to physician-owned hospitals results in overutilization and higher health care costs, the Federation of American Hospitals (FAH) and the American Hospital Association (AHA) warned in a letter to Congress, opposing new legislation which would roll back self-referral restrictions. The letter specifically opposes H.R. 1156, the ‘‘Patient Access to Higher Quality Health Care Act of 2017,” which would change current law to permit more self-referral to physician-owned hospitals.

  • February 28, 2017

    By Kayla R. Bryant, J.D.

    The American Hospital Association (AHA) believes that changes to the implementation of the Medicare Access and CHIP Reauthorization Act (MACRA) (P.L. 114-10) should wait until more data is available from providers. In a letter to the Medicare Payment Advisory Commission (MedPAC), the AHA expressed concerns about several proposals, including assigning clinicians to groups, aggregating results at the local market level, and replacing most clinician-reported measures. The AHA also addressed rising drug costs, encouraging MedPAC to focus on the issue.

  • January 10, 2017

    By Pamela Wolf, J.D.

    The year 2016 will undoubtedly be remembered as an unpredictable roller coaster for the labor and employment scene, with controversial regulations both issued by federal agencies and rolled back by the courts. And the unpredictability was seen in the courts, too, prompted by the unforeseen death of Supreme Court Justice Antonin Scalia in February and the vacancy left on the High Court for the rest of the year. The national election year also sparked heated battles over issues underscoring deep national divides, such as antidiscrimination protections for lesbian, gay, bisexual, transgender, and queer individuals, and fixing our complex immigration problem.

  • January 9, 2017

    By Carol Potaczek, J.D.

    The EBSA has issued Frequently Asked Questions (FAQs) addressing special enrollment for group health plans, coverage of preventive services, and health reimbursement arrangements (HRAs), as impacted by the implementation of the ACA, HIPAA, and the recently-enacted 21st Century Cures Act (Cures Act; P.L. 114-255). The FAQs were prepared jointly by the Labor, Treasury, and Health and Human Services departments.

  • January 6, 2017

    By Jeffrey H. Brochin, J.D.

    A recent case review of inpatient rehabilitation hospitals conducted by the HHS Office of Inspector General (OIG) found that a number of patients who were not suited for intensive post-acute rehab therapy nevertheless remained in inpatient rehab hospitals for extended periods of time. Some of the patients were in very poor condition suffering from pre-existing physical limitations, altered mental status, or unresolved health problems, or were lacking in the endurance necessary to benefit from the intensive rehab regimen prescribed. The report called upon CMS to provide additional technical assistance to ensure that Medicare patients are placed in the most appropriate setting for post-acute care ( OIG Report, No. OEI-06-16-00360, December 23, 2016).

  • January 6, 2017

    By Kayla R. Bryant, J.D.

    Aetna Life Insurance Company (Aetna) is able to recoup up to $41 million from Humble Surgical Hospital, LLC (Humble) after Humble used money received from Aetna to pay kickbacks to referring physicians. The U.S. District Court for the Southern District of Texas noted that there are three different methods for calculating the amount that Aetna may take from Humble, and gave Aetna the freedom to elect a method after Humble committed what the court deemed "guerrilla warfare against this court, Aetna, the patients, and common decency" during a case with a "tortured existence" ( Aetna Life Insurance Co. v. Humble Surgical Hospital, LLC, December 31, 2016, Hughes, L.).

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