Second Circuit Holds that Nursing Home Reimbursements from Medicare and Medicaid Do Not Impose Any Forward-Looking Conditions on How They Are Spent United States ex rel. Quartararo v. Cath. Health Sys. of Long Is. Inc., 84 F.4th 126 (2d Cir. 2023) Relator is a former employee of St. Catherine of Siena Nursing Home (the nursing … Continued

10/25/23: Contingent Reserve Requirements for Managed Care Organizations (MCOs) Notice of Adoption. The Department of Health amended Section 98-1.11(e) of Title 10 N.Y.C.R.R. to maintains the contingent reserve requirement at 7.25 percent through 2023 applied to the Medicaid Managed Care, HIV SNP and HARP programs. Filing Date: October 4, 2023. Effective Date: October 10, 2023. See N.Y. … Continued

The 2024 legislative session started with Governor Hochul presenting the State of the State address and policy book, which outlined several major investments in the areas of mental health, housing, public safety and workforce. Facing both a projected $4.3 billion deficit for the upcoming state fiscal year, and the political realities of a legislature heading … Continued

A compendium of citations to recent topics published in health law journals A Loophole in the Fourth Amendment: The Government’s Unregulated Purchase of Intimate Health Data, Rhea Bhatia, 98 Wash. L. Rev. Online 67 (2024). Abortion and the Extremism of Bright Line Rules, Teneille R. Brown, 119 Nw. U.L. Rev. Online 1 (2024). Amazon’s Acquisition … Continued

A few items of interest: 1. This column is being written in the month of February 2024 wherein the health care community and others observe(s), among other things, National Heart Health Month and World Cancer Day on the 4th of February. Ironically the observance of World Cancer Day this year coincided with the world finding out … Continued

On February 21, 2024, Change Healthcare, which is a division of United Health Group’s Optum that provides clearinghouse and other payment and revenue cycle services for health care providers and insurers, announced that it had been the target of a cyberattack by the ransomware group Blackcat/APLHV that forced it to disconnect its systems.1 According to … Continued

As of July 2023, there were more than 2,100 direct primary care practices operating in the United States, spread out over 48 states.1 As the direct primary care concept continues to grow and become an attractive model for patients, physicians and self-funded employers, it will be important to monitor the changing legal and regulatory landscape to … Continued

Background Crises such as the Coronavirus pandemic (COVID-19) required shifts away from standard hospital protocols to ensure that lives were saved.1 These shifts required consideration of how patient privacy rights may be superseded by measures to preserve public health.2 To address the demands of the COVID-19 pandemic safeguards were curtailed or eliminated to optimize patient care and … Continued

New York State Department of Health Medicaid Decisions Compiled by Dena M. DeFazio Warren Center for Rehabilitation and Nursing a/k/a Warren Operations Associates, LLC (Decision, September 7, 2023, Tina M. Champion, ALJ). Appellant is a residential health care facility (“RHCF”) located in Queensbury, New York. The New York State Office of the Medicaid Inspector General … Continued

Second Circuit Upholds Connecticut Law Repealing Religious Exemptions for Mandatory School Vaccinations We the Patriots USA, Inc. v. Connecticut Office of Early Childhood Dev., 76 F.4th 130 (2d Cir. 2023) On April 30, 2021, Governor Ned Lamont signed into law Public Act 21-6 (the “Act”), which repealed Connecticut’s religious exemption to mandatory vaccinations for school … Continued