Health Headlines – September 6, 2016

OIG Finds New Jersey Medicaid Overpaid $2.2 Million in EHR Incentives -- The HHS Office of Inspector General (OIG) recently reported that the New Jersey Department of Human Services (NJ DHS) made incorrect Medicaid electronic health record (EHR) incentive payments to 15 hospitals for a total of $2,544,870, with 10 hospitals being overpaid a total of $2,407,541 and five hospitals being underpaid a total of $137,329.  This marks the second recent report from OIG finding that State Medicaid programs made incorrect Medicaid EHR incentive payments to hospitals, and again recommends that the State repay the money to CMS and apply the alleged overpayments against future incentive payments owed to those hospitals.

As detailed in OIG’s report, the NJ DHS paid approximately $119 million in Medicaid EHR payments from February 1, 2012, through September 30, 2013.   OIG’s review of those EHR incentive payments examined 33 hospitals that received an incentive payment totaling $1 million or more during the audit period and the five highest-paid professional groups.  According to OIG report, although the NJ DHS made incorrect payments to 15 out of the 33 hospitals that were reviewed, it correctly paid the five professional groups. 

OIG’s report stated that the incorrect payments were a result of the NJ DHS program integrity contractor failing to identify certain errors and inconsistently applying the requirements of the EHR Incentive Programs.  For example, although CMS guidance states that psychiatric days and discharges cannot be included as inpatient acute-care services in the calculation of the EHR incentive payments, the calculations for five of the 33 hospitals reviewed included psychiatric services. 

As a result of the identified deficiencies, OIG made several recommendations, including that the NJ DHS refund to the Federal government $2,270,213 in net overpayments made to the 15 hospitals, analyze the payments made to the other hospitals not reviewed by OIG, and refund any additional overpayments identified.  NJ DHS agreed with the OIG’s recommendations.  As noted in the report, OIG’s review of NJ Medicaid EHR incentive payments is just one in a series of OIG reviews focusing on Medicaid EHR incentive payments to hospitals, including a review that identified Arizona as overpaying $14.8 million which was the subject of a Health Headlines article in August. 

Reporter, Christina A. McNamara, Houston, +1 713 276 7340, cmcnamara@kslaw.com. 

ALSO IN THE NEWS

Interim Final Rule Increases Civil Monetary Penalty Amounts – On September 2, 2016, the Department of Health and Human Services (HHS) released an interim final rule that “adjust[s] for inflation the maximum civil monetary penalty amounts for the various civil monetary penalty authorities for all agencies within HHS.”  The interim final rule was published in the Federal Register and goes into effect today.   The interim final rule can be found here.

OMB Completes Its Review of the Emergency Preparedness Rule for Providers – On August 29, 2016, the White House Office of Budget and Management (OMB) completed its review of a rule that updates the emergency preparedness requirements for Medicare and Medicaid providers and suppliers.  According to the abstract contained on the Office of Information and Regulatory Affairs’s website, the purpose of the rule is to ensure that participating providers and suppliers “are adequately prepared to meet the needs of patients, residents, clients, and participants during disasters and emergency situations.”  Final action is expected to be taken in December.  The original proposed rule, which was published on December 27, 2013, can be found here.  Further information about the status of the rule can be found on the Office of Information and Regulatory Affairs’s website, which is located here.

Life Sciences & Healthcare Roundtable on Medical Marijuana Set for September 8 – King & Spalding’s Life Sciences and Healthcare practice groups will host a webinar on Thursday, September 8, 2016 from 1:00 p.m. to 2:00 p.m. Eastern entitled “The Conundrum of Medicinal Marijuana: Implications for Healthcare Providers and Pharmaceutical Companies.” This webinar will, among other things, analyze the basis of the recent DEA decision to retain marijuana under Schedule 1 of the controlled substances regime, with a focus on the implications for pharmaceutical companies regarding the development of new drugs containing marijuana derivatives. Register for the webinar here.

King & Spalding Medical Device Summit 2016 – King & Spalding will host its Medical Device Summit 2016 on October 5, 2016, at the Park Hyatt Washington, D.C.  The event will be held from 8:00 a.m. until 5:00 p.m. and will be followed by a networking reception.  This year features a new one-day format with two tracks of presentations to suit attendees’ needs.  Click here for more information and to register for the program.  

King & Spalding’s FDA & Life Science’s practice group will also host a dinner on October 4, 2016, at 6:00 p.m. to kick off the Medical Device Summit and welcome you to meet our new partners and counsel in the practice group.  It will be located on the rooftop terrace of our Washington, D.C. office.  We hope that you can join us!  Please click here for more information and to RSVP.