CHANGES TO STARK LAW, NEW ADVANCE CARE PAYMENTS INCLUDED IN 2016 PHYSICIAN
FEE SCHEDULE -
The Centers for Medicare & Medicaid Services (CMS) recently published a final rule (Final Rule) regarding physician payment...more
In the last few months, the United States Department of Justice (DOJ) and the Office of Inspector General (OIG) have obtained over half a billion dollars in settlements and multiple criminal convictions arising from...more
On October 29, 2015, the Centers for Medicare & Medicaid Services and the Office of Inspector General of the Department of Health & Human Services (jointly, the “Agencies”) issued a final rule (Final Rule) regarding waivers...more
On October 28, 2015, the District Court of Appeal in the First District of Florida held in Southern Baptist Hospital, Inc. v. Jean Charles, Jr. et al. that the federal Patient Safety and Quality Improvement Act of 2005...more
The Office of the Inspector General (OIG) recently issued a favorable advisory opinion (Advisory Opinion) to an integrated health care system (System) regarding a proposed arrangement whereby the System would provide a free...more
On October 16, 2015, the Centers for Medicare & Medicaid Services (CMS) published a final rule (Final Rule) that streamlines Stage 2 and finalizes Stage 3 of the Medicare and Medicaid electronichealth record (EHR) Incentive...more
11/4/2015
/ CEHRT ,
Centers for Medicare & Medicaid Services (CMS) ,
Compliance ,
EHR ,
Electronic Health Record Incentives ,
Final Rules ,
Health Care Providers ,
Healthcare ,
Meaningful Use ,
Medicaid ,
Medicare ,
Reporting Requirements
On September 29, it was revealed that the HHS Office for Civil Rights (OCR) will commence Phase 2 of its HIPAA audit program in “early 2016.” OCR’s revelation regarding the Phase 2 audits, which had been the subject of...more
10/9/2015
/ Audits ,
Compliance ,
Cyber Attacks ,
Cyber Crimes ,
Cybersecurity ,
Data Breach ,
Data Security ,
Department of Health and Human Services (HHS) ,
Hackers ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare ,
HITECH Act ,
OCR ,
OIG ,
Privacy Rule ,
Regulatory Oversight Committee
On September 2, 2015, the U.S. Department of Health & Human Services (HHS) announced that Cancer Care Group, P.C. (CCG), a physician practice located in Indiana, agreed to pay $750,000 as part of a settlement to resolve...more
9/17/2015
/ Compliance ,
Corrective Actions ,
Cybersecurity ,
Data Breach ,
Data Protection ,
Data Security ,
Department of Health and Human Services (HHS) ,
Electronic Medical Records ,
Health Care Providers ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare ,
OCR ,
Personally Identifiable Information ,
PHI ,
Privacy Rule ,
Settlement Agreements
The U.S. Department of Justice (DOJ) recently announced that KMART Corp. (Kmart) has paid $1.4 million to settle a qui tam lawsuit brought by a former Kmart pharmacist under the False Claims Act (FCA). The lawsuit alleged...more
9/9/2015
/ Anti-Kickback Statute ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Generic Drugs ,
Healthcare ,
HEAT ,
Kickbacks ,
Kmart ,
Medicare ,
Pharmacies ,
Prescription Drugs
On August 21, 2015, the United States Court of Appeals for the District of Columbia Circuit (DC Circuit) reinstated Department of Labor (DOL) regulations that require home care agencies and other third-party employers of...more
On August 3, 2015, the United States District Court in the Southern District of New York issued a long-awaited opinion and order rejecting a motion to dismiss filed by the defendants in U.S. ex rel. Kane v. Continuum Health...more
8/21/2015
/ 60-Day Rule ,
Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
False Claims Act (FCA) ,
Health Care Providers ,
Healthcare ,
Medicaid ,
Medicare ,
Medicare Part A ,
Medicare Part B ,
Overpayment ,
Overpayment Recovery Time Limits ,
Whistleblowers
The Office of the Inspector General (OIG) recently issued a favorable advisory opinion (Advisory Opinion) to a nonprofit health system (System) and a nonprofit psychiatric hospital (Center) regarding a proposal whereby the...more
8/18/2015
/ Advance Directives ,
Affordable Care Act ,
Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Employees ,
Fair Market Value ,
FQHC ,
Health Care Providers ,
Healthcare ,
Medicaid ,
Medicare ,
Non-Profit Hospitals ,
OIG ,
Physician Fee Schedule ,
Physicians ,
Rural Health Care Providers ,
Stark Law ,
Timeshare
On June 29 and 30, 2015, the Connecticut General Assembly conducted a special legislative session following the close of the 2015 regular session. Among other things, the General Assembly passed a bill to implement the state...more
8/13/2015
/ Audits ,
Certificate of Need ,
DSS ,
FQHC ,
Health Care Providers ,
Healthcare ,
HIV ,
Home Healthcare Workers ,
Hospitals ,
Medicaid ,
Medicaid Reimbursements ,
Medical Reimbursement ,
Municipalities ,
Nurses ,
Nursing Homes ,
Pay-for-Performance ,
Personal Property ,
Prescription Drugs ,
Property Tax ,
Public Health ,
Reporting Requirements ,
Screening Procedures ,
Tax Rates
On July 10, the U.S. House of Representatives approved the 21st Century Cures Act (the Act), a bill intended to support advancements in medical innovation. The Act includes measures aimed at spurring medical research,...more
Effective October 1, 2015, this legislation contains several provisions to encourage the free exchange of patient health information among providers and consumers. Hospitals, health systems, and electronic health record (EHR)...more
Effective October 1, 2015, this legislation requires the Connecticut Health Insurance Exchange (HIX) to establish, by July 1, 2016, a consumer health information website that contains information comparing the quality, price,...more
President Obama recently signed into law Public Law No. 114-10, the “Medicare Access and CHIP Reauthorization Act of 2015” (P.L. 114-10), which overhauls Medicare physician reimbursements by eliminating the use of the...more
On May 26, 2015, Connecticut Governor Dannel P. Malloy signed into law Public Act 15-11 (PA 15-11), “An Act Concerning Persons Who Decontaminate Reusable Medical Instruments or Devices.” This new legislation requires central...more
On March 30, 2015, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule (Proposed Rule) setting forth meaningful use criteria for Stage 3 of the Medicare and Medicaid Electronic Health Record Incentive...more
On May 11, 2015, Connecticut Governor Dannel P. Malloy signed into law Public Act 15-4, “An Act Concerning Reporting of Payments by Manufacturers to Independently-Practicing Advanced Practice Registered Nurses” (P.A. 15-4)....more
Reports of security breaches involving health care information have become increasingly prevalent in recent years, and such breaches seem to be continually growing in scope and magnitude. In the April 14, 2015, issue of JAMA,...more
The Centers for Medicare and Medicaid Services (CMS) recently published a proposed rule (Proposed Rule) implementing Stage 3 of the Medicare and Medicaid electronic health record (EHR) Incentive Programs (Meaningful Use...more
On March 10, 2015, the Internal Revenue Service (IRS) released Revenue Procedure 2015-21 (Revenue Procedure), which will be officially published on March 30, 2015, in Internal Revenue Bulletin 2015-13. The Revenue Procedure...more
The Centers for Medicare and Medicaid Services (CMS) announced on February 13, 2015, that it will delay publishing final regulations concerning the “60-Day Rule.” The final rule will be published on or before February 17,...more
The Ninth Circuit Court of Appeals and a Massachusetts Superior Court each recently released decisions dealing with alleged violations of antitrust prohibitions that implicate a number of important issues surrounding health...more