The Centers for Medicare and Medicaid Services (CMS) has proposed a new amendment that could significantly modify the standard governing identification of overpayments by providers....more
In an effort to ease achieving compliance with its newly instituted Hospital Price Transparency Rule, the Centers for Medicare & Medicaid Services (CMS) has recently published three sample formats on its website for hospitals...more
In a setback for Pennsylvania health care providers, the Supreme Court of Pennsylvania approved an order amending the rules pertaining to the venue in which medical malpractice suits may be brought. The Pennsylvania Rules of...more
The Department of Justice recently reported that in fiscal year 2021, it received more than $5.6 billion in settlements and judgments. Of that total, over $5 billion relates to matters that involved the health care industry....more
The Centers for Medicare & Medicaid Services’ (“CMS”) message this year has been consistent – hospitals need to comply with CMS’ Hospital Transparency Rule. This rule requires hospitals and health systems to disclose a...more
The West Virginia Supreme Court issued a new memorandum decision which broadly interprets the scope of the West Virginia Medical Professional Liability Act, applying it to entities who were not recipients of health care...more
The Office of Inspector General’s (“OIG”) new Anti-Kickback Statute (“AKS”) regulations modify the safe harbor for personal services and management contracts (42 CFR § 1001.952(d)) in a manner that allows providers...more
5/24/2021
/ Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Health Care Providers ,
Hospitals ,
Management Contracts ,
New Rules ,
OIG ,
Personal Services ,
Physicians ,
Proposed Rules ,
Safe Harbors ,
Stark Law ,
Value-Based Care
The Centers for Medicare & Medicaid Services’ (“CMS”) new final rule amending the implementing regulations of the Physician Self-Referral Law (“Stark Law”), in part, defines fundamental terms, such as “fair market value” and...more
A recent $100 million verdict serves as a grim reminder for health care providers of the risk of paying independent contractors to market services. In United States v. Mallory, et al., the United States Court of Appeals for...more
On February 24, 2021, the Office for Civil Rights at the U.S. Department of Health and Human Services (“OCR”) announced that it will not impose penalties against covered entities or their business associates that use online...more
3/4/2021
/ Coronavirus/COVID-19 ,
Covered Entities ,
Data Storage ,
Encryption ,
Health Care Providers ,
Health Insurance Portability and Accountability Act (HIPAA) ,
OCR ,
Penalties ,
PHI ,
Secure Scheduling ,
Vaccinations
A January 20, 2021 memo issued by the Biden Administration may freeze the implementation of the Stark Law and Anti-kickback Statute (“AKS”) final rules that went into effect on January 19, 2021. According to the U.S....more
2/18/2021
/ Anti-Kickback Statute ,
Biden Administration ,
Civil Monetary Penalty ,
CRA ,
Final Rules ,
GAO ,
Health Care Providers ,
Regulatory Freeze ,
Safe Harbors ,
Stark Law ,
Value-Based Care
On January 1, 2021, hospitals and health systems will be required to comply with Hospital Price Transparency requirements or face possible penalties from the Centers of Medicare and Medicaid Services (CMS). This rule requires...more
The U.S. Department of Health and Human Services (“HHS”) recently issued two corresponding final rules amending the implementing regulations of the Physician Self-Referral Law (“Stark Law”), the Anti-Kickback Statute (“AKS”),...more
As the country prepares to end the fight against COVID-19, questions regarding the distribution of vaccines have understandably been at the forefront of the minds of Long-Term Care Facilities (“LTCF”). Indeed, those questions...more
12/10/2020
/ Centers for Disease Control and Prevention (CDC) ,
Coronavirus/COVID-19 ,
First Responders ,
Health Care Providers ,
Healthcare Workers ,
Legislative Agendas ,
Long Term Care Facilities ,
Nursing Homes ,
Patients ,
Pharmaceutical Industry ,
State and Local Government ,
Vaccinations
Under the HIPAA Privacy Rule, individuals have a right to timely access their medical records at a reasonable cost. With some exceptions, a health care provider must provide those records without reasonable delay and within...more
On October 31, 2019, the Supreme Court of Pennsylvania decided Yanakos v. UPMC, et al. and declared the seven-year statute of repose under the Pennsylvania Medical Care Availability and Reduction of Error (“MCARE”) Act...more
11/14/2019
/ Appeals ,
Cause of Action Accrual ,
Compelling Governmental Interest ,
Constitutional Challenges ,
Health Care Providers ,
Malpractice Insurance ,
Medical Malpractice ,
PA Supreme Court ,
Standard of Care ,
State Legislatures ,
Statute of Repose ,
Time-Barred Claims
On September 5, 2019, the Centers for Medicare & Medicaid Services (CMS) announced a final rule expanding CMS’ authority to deny or revoke enrollment in the Medicare program as a result of “bad actor” affiliations. Providers...more
10/2/2019
/ Bad Actors ,
Centers for Medicare & Medicaid Services (CMS) ,
Children's Health Insurance Program (CHIP) ,
Disclosure Requirements ,
Enrollment ,
Final Rules ,
Health Care Providers ,
Medicaid ,
Medicare ,
Revocation ,
Suppliers
On July 16, 2019, the Centers for Medicare & Medicaid Services (CMS) announced a final rule that lifted the ban on the use of pre-dispute, binding arbitration agreements by long term care facilities. Under the Obama...more
Prescribers in West Virginia are bound by new restrictions set forth in the Opioid Reduction Act, aimed at combating the opioid crisis in West Virginia. The Act was enacted by the state legislature to limit patient access in...more
A recent decision by the Supreme Court of Appeals of West Virginia draws a sharp line of distinction for hospitals responding to nonparty subpoenas against the unauthorized disclosure of confidential mental health records. In...more
6/12/2018
/ Confidential Information ,
Discovery ,
Health Care Providers ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Medical Records ,
Motion to Compel ,
Motions to Quash ,
Non-Parties ,
Policies and Procedures ,
Subpoenas ,
Written Consent
A recent decision by the West Virginia Supreme Court of Appeals could significantly increase the potential for litigation arising from adverse privileging decisions by healthcare institutions in the state. Under the Court’s...more
Following recent international cyber attacks, the U.S. Department of Health and Human Services (HHS) has issued warnings to healthcare organizations, provided a cyber attack checklist, and launched its revised HIPAA Breach...more
In a 4-3 decision, the Supreme Court of Pennsylvania, overturning a Superior Court’s order, ruled that a jury could not consider information provided by the physician’s qualified staff in deciding whether a physician obtained...more