Tag Archives: Bipartisan Budget Act of 2015

Health Care Providers May Soon See a Twofold Increase in False Claims Act Penalties

In fiscal year 2015, the U.S. Department of Justice (“DOJ”) recovered more than $3.5 billion from False Claims Act (“FCA”) cases. A staggering $1.9 billion of that amount was recovered from health care providers who were alleged to have provided unnecessary care, paid kickbacks or overcharged federal health care programs.  While this amount may seem high, the drastic increases in FCA penalties expected this summer have the potential to skyrocket FCA recoveries in coming years. DOJ has not yet released the increased penalty amounts that would apply to FCA cases involving companies in the health care and life sciences industries, but penalty increases released this month by another agency, the U.S. Railroad Retirement Board (“Railroad Board),[1] seem to be a good indication of what providers can expect.

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Healthcare: Budget deal will impact hospital acquisitions of physician practices

On Monday, President Barack Obama signed the Bipartisan Budget Act of 2015 into law. Medicare site neutral payment provisions in Section 603 of the act will restrict the ability of health systems to benefit from Medicare hospital outpatient reimbursement rates after acquiring a physician practice or ambulatory surgery center.

This landmark legislation provides the framework for the federal budget for the next two years, ensures the Department of Treasury does not default on its federal debts, replaces the across-the-board spending cuts called “sequestration” with more targeted cuts, and sets forth other policy changes. 

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Bipartisan Budget Act of 2015 – Potential Impact on Hospitals

House Republican leaders introduced legislation on Monday, finalizing a two-year budget agreement between Congressional leaders and the White House. This legislation is currently being considered and may be up for a vote as early as Wednesday on the bipartisan budget deal.

Hospitals should note the language in Section 603 (which is on pages 35-39 of the draft bill) codifies the definition of a “provider-based off-campus hospital outpatient department” (PBD HOPD) as a location that is not on the main campus of a hospital and is located more 250 yards from the main campus. 

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