Law.com Subscribers SAVE 30%
Call 855-808-4530 or email [email protected] to receive your discount on a new subscription.
Limiting Successor Liability Under Assigned Medicare Provider Agreements
Recent years have seen an uptick in distressed health-care mergers and acquisitions as providers and systems struggle to adjust to a changing economic climate. Significant changes have taken place in health care service delivery as a result of the enactment of the Patient Protection & Affordable Care Act (“Obamacare”) in 2010. Expenditures have increased due to the cost to implement reforms, including capital investments in information technology systems and new patient care and integration models. At the same time, revenues have decreased due to the availability of fewer government funds and the government's efforts to reduce Medicare-related costs. As a result, more and more health care providers have turned to reorganization and consolidation as a means of remaining viable. This article aims to inform readers of the risks associated with accepting assignment of a distressed health care provider's Medicare provider agreement, as well as providing suggestions for managing those risks.
Medicare Provider Agreements and the Prospective Payment System
One source of a health care provider's value is its Medicare provider agreement. This agreement between a health care provider and the Secretary of the United States Department of Health and Human Services enables the provider to receive payment from the federal government for services provided to Medicare beneficiaries pursuant to Title XVIII of the Social Security Act, also known as the “Medicare Statute.” Pursuant to the Medicare provider agreement, the health care provider agrees to provide services and comply with the Medicare Statute, and the government agrees to reimburse the provider for Medicare-eligible expenses. In connection with entry into the Medicare provider agreement, each health care provider is issued a provider billing number under which it may submit claims for reimbursement of covered goods and services.
This premium content is locked for Entertainment Law & Finance subscribers only
ENJOY UNLIMITED ACCESS TO THE SINGLE SOURCE OF OBJECTIVE LEGAL ANALYSIS, PRACTICAL INSIGHTS, AND NEWS IN ENTERTAINMENT LAW.
- Stay current on the latest information, rulings, regulations, and trends
- Includes practical, must-have information on copyrights, royalties, AI, and more
- Tap into expert guidance from top entertainment lawyers and experts
Already a have an account? Sign In Now Log In Now
For enterprise-wide or corporate acess, please contact Customer Service at [email protected] or 877-256-2473
Major Differences In UK, U.S. Copyright Laws
This article highlights how copyright law in the United Kingdom differs from U.S. copyright law, and points out differences that may be crucial to entertainment and media businesses familiar with U.S law that are interested in operating in the United Kingdom or under UK law. The article also briefly addresses contrasts in UK and U.S. trademark law.
The Article 8 Opt In
The Article 8 opt-in election adds an additional layer of complexity to the already labyrinthine rules governing perfection of security interests under the UCC. A lender that is unaware of the nuances created by the opt in (may find its security interest vulnerable to being primed by another party that has taken steps to perfect in a superior manner under the circumstances.
Strategy vs. Tactics: Two Sides of a Difficult Coin
With each successive large-scale cyber attack, it is slowly becoming clear that ransomware attacks are targeting the critical infrastructure of the most powerful country on the planet. Understanding the strategy, and tactics of our opponents, as well as the strategy and the tactics we implement as a response are vital to victory.
Legal Possession: What Does It Mean?
Possession of real property is a matter of physical fact. Having the right or legal entitlement to possession is not "possession," possession is "the fact of having or holding property in one's power." That power means having physical dominion and control over the property.
The Stranger to the Deed Rule
In 1987, a unanimous Court of Appeals reaffirmed the vitality of the "stranger to the deed" rule, which holds that if a grantor executes a deed to a grantee purporting to create an easement in a third party, the easement is invalid. Daniello v. Wagner, decided by the Second Department on November 29th, makes it clear that not all grantors (or their lawyers) have received the Court of Appeals' message, suggesting that the rule needs re-examination.