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Limitations on Medicaid Liens in Personal Injury Recoveries ( July 2007 )
As with other Medicaid payors, the Oregon Department of Human Services (ODHS) is compelled by state law to seek reimbursement out of personal injury recoveries for paid Medicaid benefits. The lien rights of such state agencies are not without limitation, however, and those limitations can make a huge difference for clients when their damages exceed the available liability coverage. -
Problematic Gifting ( October 2006 )
There are many misguided beliefs about reducing assets to qualify for Medicaid long-term care benefits. In fact, one of the most commonly mistaken beliefs is that a Medicaid applicant or potential applicant can simply gift or transfer assets to another person or into another person's name in order to qualify for Medicaid benefits. As this article explains, the gifting of assets can disqualify an individual from receiving benefits to pay for nursing home care for a significant period of time. -
In May 2003, the United States Supreme Court rendered a decision of significant interest to pharmaceutical manufacturers in Pharmaceutical Research & Mfrs. of Am. v. Walsh, 538 U.S. 644, 123 S.Ct. 1855 (2003). Although the full impact of the Walsh decision will not be known until the case is decided on the merits – the Supreme Court's May 2003 ruling merely affirmed that a district-court injunction was improper and returned the case to the lower courts for merits determination – the Walsh litigation may materially impact how prescription drugs are priced.
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The 2003 Medicare Prescription Drug, "Improvement" And Modernization Act Provides Increased Revenue Opportunities ( December 2003 )
Signed into law on Dec. 8, 2003, the Medicare Prescription Drug, Improvement and Modernization Act, P.L. 108-173 (the "Act"), with close to 200 major sections, has been called the largest overhaul to the Medicare Program since its inception. The Act not only creates a historic prescription drug benefit, but makes significant payment changes to Medicare Part A and Part B, and Medicaid. Congress has hailed the Act as correcting existing payment "inequities." -
Long Term Care ( January 1999 )
As our population ages, increasing numbers of individuals will require long term health care services. Services provided by home health agencies allow elderly individuals to receive medical and supportive assistance while remaining at home. Assisted living facilities serve those who cannot live on their own, i.e. , they require assistance with bathing, dressing, ambulating and the other activities of daily living. For those who require more complex or round-the-clock health services, nursing homes may be the best alternative. -
HHS Issues Final and Substantially Revised Privacy Rule ( December 2000 )
This Shaw Pittman Alert reviews the Department of Health and Human Services final standards for privacy of individually identifiable health information. -
Hospitals Benefit from Medicare and Medicaid Giveback Legislation ( December 2000 )
This alert summarizes the recently enacted the Medicare, Medicaid and SCHIP Benefits Improvement and Protection Act of 2000 that will yield financial and regulatory relief to hospitals participating in the Medicare program. -
Prospective Payment System Final Rule For Hospital Outpatient Services Released-April 2000 ( October 2000 )
The Health Care Financing Administration ("HCFA") published its final regulation regarding the outpatient prospecti. -
Prospective Payment System Final Rule Implementation Delayed ( October 2000 )
Shortly after the June 2000 issue of Update went to print, the Health Care Financing Administration (HCFA) announce. -
HHS Releases Final Rule for Standards for Electronic Transactions and Code Sets ( September 2000 )
This alert reviews the Department of Health and Human Services final rule which adopts the standards for eight electronic transaction and code sets. These regulations comply with the administrative simplification provisions of the Health Insurance Portability and Accountability Act of 1996.
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