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Department of Labor Final Rule Changes Overtime Regulations

Dramatically Expanding Who is Entitled to Overtime Pay

On May 18, 2016, the Department of Labor’s Wage and Hour Division announced the upcoming publication (on May 23, 2016) of a Final Rule intended to update and modernize the regulations governing the exemption of executive, administrative and professional employees from the overtime pay protections of the Federal Fair Labor Standards Act (FLSA).  Among other things, this...

OIG Newly Updated Exclusion Criteria as of April 18, 2016

On April 18, the OIG updated the criteria it uses to determine whether exclusion or a lesser penalty is the appropriate remedy – underscoring the renewed emphasis the OIG is placing on this important weapon in its arsenal to fight against fraud and abuse.   

The Office of Inspector General (OIG) has the authority to exclude individuals or entities (collectively “person”) that engage in illegal or fraudulent conduct from participation in Federal health care programs to protect the...

CMS Passes 60-Day Overpayment Final Rule

On February 12, 2016, the Centers for Medicare and Medicaid Services (CMS) published a Final Rule that provides guidelines to Medicare providers about their duty to report and return overpayments.  These new regulations define what it means to “identify” an overpayment and provide detailed guidance regarding Medicare providers’ overpayment obligations. 


The NLRB's "Quickie Election" Rules

The National Labor Relations Board (NLRB) recently modified its union election rules and these changes went into effect on April 14, 2015.  Commonly referred to as the “quickie election rules,” the new procedures increase administrative burdens for employers and speed up the election process.  The bottom line is that employers will have less time to conduct an effective communications program and tackle important issues during a union election.    



3 Things You Must Know for 2015

The new HIPAA regulations are here and providers are being hit with million dollar settlements as the government gears up for its biggest round of HIPAA audits in 2015.  The big question is, are you ready?  Recent HIPAA settlements reveal that simply updating your Notice of Privacy Practices (NPP) and business associate agreements (BAA) isn’t going to cut it. 


CMS Finalizes New Fraud Safeguards Including Ambulance Backbilling

#000000;">The Centers for Medicare & Medicaid Services (CMS) just issued a #0000CD;">Final Rule#000000;"> intended to improve CMS’s ability to deny or revoke the enrollment of entities and individuals that pose an integrity risk to the Medicare program.  This Rule would also significantly limit ambulance suppliers' ability to...

CMS Issues Notice About Prior Authorization Model in PA, NJ and SC

Requests Can Start on December 1, 2014

On November 13, 2014, CMS issued a Notice in the Federal Register officially announcing a 3-year Medicare Prior Authorization model for repetitive scheduled non-emergent ambulance transports in the states of New Jersey, Pennsylvania, and South Carolina.  The new model means that certain ambulance services in these three states must soon obtain prior authorization for repetitive, scheduled non-emergent transports by submitting a host of documentation to their Medicare Administrative...

PWW Summary of Final 2015 Ambulance Fee Schedule Rule

Many ZIP Codes Going From Rural to Urban

On November 13, 2014, the Centers for Medicare and Medicaid Services (CMS) issued a Final Rule that updates regulations to account for the ambulance bonuses and changes many ZIP code designations for purposes of Medicare reimbursement.  The Rule, Medicare Program; Revisions to Payment...

OIG Proposes Safe Harbor for Cost-Sharing Waivers for Emergency Ambulance Services

On October 3, 2014 the Office of the Inspector General is set to publish a Proposed Rule that would establish a new safe harbor under the Anti-Kickback Statute (AKS) that would permit waivers of cost-sharing amounts for emergency ambulance services furnished by State or municipally-owned ambulance providers and suppliers.  But, there are conditions that must be met in...