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Articles by Travis Lloyd
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Hey Bigger Pockets!! Looking at purchasing a turnkey property in Rowlett Texas and I was wondering how best to estimate property taxes from my analysis. Example: If the historical assessed price of the property is $100K and the purchase price is $150K would should I use as the post purchase assessment value? I guess as a worst case scenario I can use the tax percentage from the county records and multiply that against the purchase price...but I'm being told that is not how it works in Texas.
CMS Announces Model for Technology-Assisted Chronic Condition Management | JD Supra
On December 1, the Centers for Medicare & Medicaid Services (CMS) announced the Advancing Chronic Care with Effective, Scalable Solutions Model (ACCESS), a 10-year voluntary alternative payment model (APM) that will pay participating organizations recurring, outcome-aligned payments for providing technology-supported care to manage common chronic conditions.
CMS Launches Mandatory Two-Sided Risk Model for Specialists Treating Heart Failure and Low Back Pain | JD Supra
On October 31, the Centers for Medicare & Medicaid Services (CMS) finalized the Ambulatory Specialty Model (ASM), a mandatory alternative payment model (APM) for select specialists who regularly treat heart failure or low back pain.
CMS Proposes Mandatory Two-Sided Risk Model for Specialists Treating Heart Failure and Low Back Pain | JD Supra
On July 16, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule for the Ambulatory Specialty Model (ASM), a mandatory, five-year alternative payment model for select specialists who regularly treat heart failure or low back pain.
OIG Declines to Approve Medical Device Company's Proposal to Subsidize Screening Costs | JD Supra
On June 20, the U.S. Department of Health and Human Services Office of Inspector General (OIG) published Advisory Opinion 25-04, in which it declined to approve a proposal by a medical device company (Requestor) to pay the costs its customers otherwise would incur for a third-party company to screen and monitor Requestor for exclusion from federal healthcare programs (FHCPs) and other compliance checks.
A New Year, A New Overpayment Rule: CMS Revises the 60-Day Rule | JD Supra
On December 9, the Centers for Medicare & Medicaid Services (CMS) published revised regulations implementing the so-called 60-day rule, under which healthcare providers and other parties generally must report and return any overpayment within 60 days after they have identified it.
Second Circuit Clarifies Anti-Kickback Statute’s Scienter Requirement | JD Supra
On March 12, the U.S. Court of Appeals for the Second Circuit issued an important decision that sheds light on the test for determining scienter under the federal Anti-Kickback Statute (AKS).
OIG Approves the Use of Gift Cards to Reward Customers' Marketing Efforts | JD Supra
On January 3, the U.S. Department of Health and Human Services Office of Inspector General (OIG) posted Advisory Opinion 23-15, approving a physician practice consultant’s proposal to offer gift cards to its customers when they recommend the requestor’s services to other physician practices.
OIG Approves Paying Employed Physicians Profits from ASCs Operated by Employer | JD Supra
On October 13, the U.S. Department of Health and Human Services Office of Inspector General (OIG) issued Advisory Opinion 23-07, approving a physician practice’s proposal to pay its physician-employees a portion of the facility fee profits from procedures they perform at ambulatory surgical centers (ASCs) operated by the practice.
OIG Approves Online Platform's Per-Booking Fees for Medical Appointments and Per-Click Fees for Advertisements | JD Supra
The U.S. Department of Health and Human Services Office of Inspector General (OIG) recently issued Advisory Opinion 23-04, approving the per-booking fees healthcare providers pay a technology company for each new patient who books an appointment through the company’s online platform and the per-click and per-impression fees the company charges for advertising on the platform.
CMS Publishes New Data on Self-Referral Disclosure Protocol Settlements | JD Supra
The Centers for Medicare & Medicaid Services (CMS) recently published updated data regarding settlements made under the Voluntary Self-Referral Disclosure Protocol (SRDP), an important mechanism through which providers may disclose actual or potential violations of the federal physician self-referral prohibition commonly known as the Stark Law.
OIG Offers Guidance for ASCs When Physician-Investors Fail the One-Third Income Test | JD Supra
Nearly 25 years ago, the Office of Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS) created a regulatory safe harbor to the federal Anti-Kickback Statute (AKS) for physician investment in ambulatory surgical centers (ASCs).
2022: HHS-OIG Year In Review
Introduction The Office of Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS) continues to offer valuable insights to the healthcare industry as to how best to approach increasingly complex healthcare fraud and abuse issues. Bass, Berry & Sims is pleased to share this HHS-OIG Year In Review (HHS-OIG YIR) that highlights key guidance OIG issued in 2022, as well as other items of import involving the agency.
OIG Offers Stakeholders a New Avenue for Informal Fraud and Abuse Guidance | JD Supra
On March 23, the Office of Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS) announced a new, expanded frequently asked questions (FAQs) process. Although OIG has long maintained FAQs on topics such as exclusion authorities, it has addressed only a limited range of issues.
11th annual Healthcare Fraud & Abuse Review 2022
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We are pleased to bring you our 11th annual Healthcare Fraud & Abuse Review. Our Review provides comprehensive coverage of the most significant civil and criminal enforcement issues facing healthcare providers. Each year, we endeavor to cover key enforcement initiatives, analyze important case developments and document healthcare fraud settlements across the industry, and present those topics in a readily digestible format for our readers.
By Angela Bergman, Kristin M. Bohl, J. Taylor Chenery, Matthew M. Curley, Lindsey Brown Fetzer, Lauren Gaffney, Scott Gallisdorfer, Jeff Gibson, Anna Grizzle, Brian Irving, Stewart W. Kameen, Travis Lloyd, William T. Mathias, Jennifer Michael, Lisa S. Rivera, Brian Roark, Glenn Rose, Molly Ruberg, Danielle Sloane, Julia Tamulis, Nathan Brown, Hannah Choate, Maleaka Guice, Dee Harleston, Sheaniva Murray, Heather Pearson, Brianna Powell, Peter Rathmell, Taylor Sample, Rhea Shinde, Page Minton Smith, Briana Sprick Schuster, Jamie Steakley, Hannah C. Webber, Abby Yi, John C. Eason, Michael K. Bassham, Garrah Carter-Mason
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CMS Tweaks Voluntary Self-Referral Disclosure Protocol, Adds New Form for Group Practice Disclosures
On January 23, the Centers for Medicare & Medicaid Services (CMS) released revisions to its Voluntary Self-Referral Disclosure Protocol (SRDP), an important mechanism through which providers may disclose actual or potential violations of the federal physician self-referral prohibition commonly known as the Stark Law.
OIG Approves Hospital Provision of Nurse Practitioner Services in Advisory Opinion | JD Supra
January 6, 2023 Anna Grizzle, Travis Lloyd, Jennifer Michael, Angelique Salib Bass, Berry & Sims PLC + Follow x Following x Following - Unfollow Contact To embed, copy and paste the code into your website or blog: The Office of Inspector General (OIG) for the U.S. Department of Health and Human Services recently posted Advisory Opinion 22-20, approving an acute care hospital’s arrangement under which its employed nurse practitioners perform certain services that the patients’ primary care...
OIG Releases Advisory Opinion Request Template | JD Supra
The Office of Inspector General (OIG) for the U.S. Department of Health and Human Services recently released a template that parties may use when preparing advisory opinion requests. The voluntary template provides a simple framework that can serve as a useful starting point for advisory opinion requests but may not accommodate every request.
CMS Proposes New Stark Law Exception for Rural Emergency Hospitals | JD Supra
On July 15, the Centers for Medicare & Medicaid Services (CMS) published the Calendar Year 2023 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgery Center (ASC) Payment System proposed rule.
Sponsoring Continuing Education Programs—OIG Weighs in with Advisory Opinion 22-14 | JD Supra
July 6, 2022 Krista Cooper, Stewart Kameen, Travis Lloyd, Jennifer Michael Bass, Berry & Sims PLC + Follow x Following x Following - Unfollow Contact To embed, copy and paste the code into your website or blog: On June 29, the Office of Inspector General (OIG) for the U.S. Department of Health and Human Services published Advisory Opinion 22-14, approving in part, and denying in part, a request from an ophthalmology practice (Requestor) regarding four variations of its proposed continuing...
OIG Declines to Approve Lab’s Payment of Specimen Collection Fees to Hospitals | JD Supra
On April 28, the Office of Inspector General (OIG) for the U.S. Department of Health and Human Services published Advisory Opinion 22-09, declining to approve a laboratory company’s proposal to pay hospitals a fair market value, per-patient-encounter fee to collect, process, and handle specimens. OIG declined to approve the arrangement for two key reasons. First, in OIG’s view, lab services are particularly susceptible to the risk of steering under the federal Anti-Kickback Statute.
OIG Permits Physician-Employer to Retain Profits from Anesthesia Services Provided by CRNA in Physician Office and ASC | JD Supra
A pain management practice that employs a certified registered nurse anesthetist (CRNA) to provide anesthesia services in both an office location and an ambulatory surgery center (ASC) owned, in part, by the physician-owner of the practice was given the green light by the Office of Inspector General (OIG) to retain profits earned pursuant to a reassignment of billing rights.
CMS Revises Stark Law Indirect Compensation Arrangement Definition, Again | JD Supra
The CY 2022 Medicare Physician Fee Schedule final rule includes further revisions to the definition of the term “indirect compensation arrangement” under the federal physician self-referral prohibition (Stark Law). Less than a year ago, the Centers for Medicare & Medicaid Services (CMS) finalized a major revision to the indirect compensation arrangement definition as part of its Regulatory Sprint rule.
Federal Agencies Release Interim Final Rule to Implement the No Surprises Act | JD Supra
Today, the Departments of Health and Human Services (HHS), Labor, and Treasury (the Departments) published an interim final rule (the Interim Final Rule) implementing certain provisions of the No Surprises Act,[1] which aims to address balance bills on a national scale.
Federal District Court Applies Expansive Definition of “Referral” to Find Liability under the Anti-Kickback Statute
Wednesday, June 23, 2021 Despite its central importance to the application of the federal anti-kickback statute, 42 U.S.C. § 1320a-7b(b) (AKS), the term “refer” is not defined by statute or regulation, and it has seldom been interpreted by the courts or regulatory agencies. Following the lead of the U.S. Court of Appeals for the Seventh Circuit, a recent federal district court decision suggests that the term may reach further than many expect. In Stop Illinois Health Care Fraud, LLC v.
The Ongoing Saga of the CMS Hospital Price Transparency Rule | JD Supra
The Centers for Medicare & Medicaid Services (CMS) Hospital Price Transparency Rule went into effect on January 1, 2021, but whether it will succeed in making prices readily comparable for healthcare consumers remains to be seen. Since introducing the rule in late 2019, CMS has battled resistance from industry stakeholders on several fronts, from a barrage of negative comments on the initial design of the rule to a multi-stage legal challenge in federal court.
The Ongoing Saga of the CMS Hospital Price Transparency Rule
Wednesday, May 12, 2021 The Centers for Medicare & Medicaid Services (CMS) Hospital Price Transparency Rule went into effect on January 1, 2021, but whether it will succeed in making prices readily comparable for healthcare consumers remains to be seen. Since introducing the rule in late 2019, CMS has battled resistance from industry stakeholders on several fronts, from a barrage of negative comments on the initial design of the rule to a multi-stage legal challenge in federal court.
Information Blocking Rule Compliance Date Extended Due to Pandemic | JD Supra
The U.S. Department of Health and Human Services (HHS) Office of the National Coordinator for Health Information Technology (ONC) released an interim final rule on October 29, 2020, delaying the implementation of the information blocking rule under the 21st Century Cures Act (Information Blocking Rule).
“Ownership” and the Lean Startup
Here at Paladin, we’re big fans of the Lean product philosophy. While each new feature that we build goes through a thorough design process, the goal is always to release something as quickly as possible. This focus on iterative development keeps us responsive to our users and allows us to test new ideas before we double down on them.
SAMHSA Finalizes Revisions to Part 2 Regulations Governing Confidentiality of Substance Use Disorder Records | JD Supra
On July 15, 2020, the Substance Abuse and Mental Health Services Administration (SAMHSA), a branch of the U.S. Department of Health and Human Services (HHS), published its much-anticipated final rule to revise 42 C.F.R. Part 2, a set of federal regulations governing the confidentiality of substance use disorder (SUD) patient records.
Tips For Applying COVID-19 Stark Law Waivers
By Travis Lloyd Law360 is providing free access to its coronavirus coverage to make sure all members of the legal community have accurate information in this time of uncertainty and change. Use the form below to sign up for any of our daily newsletters. Signing up for any of our section newsletters will opt you in to the daily Coronavirus briefing.
HHS Proposes Revisions to Part 2 Regulations Governing Confidentiality of Substance Use Disorder Records - Healthcare Alert | JD Supra
Updated: May 25, 2018: JD Supra is a legal publishing service that connects experts and their content with broader audiences of professionals, journalists and associations.
Significant Changes to Florida’s Patient Brokering Act: Uncertainty Lies Ahead - Healthcare Alert | JD Supra
Updated: May 25, 2018: JD Supra is a legal publishing service that connects experts and their content with broader audiences of professionals, journalists and associations.
DOJ Evaluation of Corporate Compliance Programs - Government Enforcement Update | JD Supra
Updated: May 25, 2018: JD Supra is a legal publishing service that connects experts and their content with broader audiences of professionals, journalists and associations.
Coordinating Care, Reducing Burden: OIG Issues Favorable Advisory Opinion Regarding Follow-up Care Arrangements for Chronic Conditions - Healthcare Alert | Bradley Arant Boult Cummings LLP - JDSupra
Updated: May 25, 2018: JD Supra is a legal publishing service that connects experts and their content with broader audiences of professionals, journalists and associations.
CMS Continues Shift toward Value-Based Payments with New Home Health Groupings Model in Proposal - Healthcare Alert | JD Supra
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CMS Releases Innovation Center New Direction RFI Feedback and Issues New RFI for Direct Provider Contracting | JD Supra
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2017 - The Health Law Year in Review
Uncertain. What better word to describe a year in which a new administration came to power and began to chart a new course for health policy, the fate of the Affordable Care Act (ACA) hung in the balance, and courts grappled with the meaning of a momentous decision involving the federal False Claims Act (FCA)? 2017 was marked by significant changes that have left many wondering what’s next. What will come of the federal health insurance exchanges without the individual mandate?
What Exactly Is a Hospital, Anyway? CMS Issues Guidance on “Primarily Engaged” Medicare Certification Requirement
The rules that govern participation in the Medicare program are notoriously voluminous and complex.
EMTALA Settlement Highlights Continuing Challenges for Hospitals
After 30 years as a fixture in the federal healthcare regulatory landscape, the Emergency Medical Treatment and Labor Act—more commonly known as EMTALA—has been in the news again.
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