In the February 12, 2016 Federal Register, the Centers for Medicare & Medicaid Services (CMS) published a final rule (Final Rule) with respect to reporting and returning overpayments by Medicare Part A and Part B providers to...more
For those covered entities who experienced one or more HIPAA breaches involving less than 500 individuals during the calendar year 2015, the deadline for reporting those breaches to the Secretary of the U.S. Department of...more
The January 6, 2016 Federal Register included a final rule (“Final Rule”) amending the HIPAA Privacy Rule to expressly permit certain “covered entities” to disclose to the National Instant Criminal Background Check System...more
On December 14, 2015, the U.S. Department of Health and Human Services, Office for Civil Rights (OCR) announced a $750,000 settlement with the University of Washington (UW). This is the third HIPAA settlement announced by OCR...more
The U.S. Department of Health and Human Services, Office of Civil Rights (OCR), has announced a settlement with Lahey Hospital and Medical Center (Lahey) that arose out of a HIPAA breach involving a stolen laptop. The...more
In November 2015, the Office of Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS) released its investigative plans for fiscal year 2016 (the OIG Work Plan). The OIG Work Plan highlights more...more
On Thursday, October 29, 2015, the Centers for Medicare & Medicaid Services (“CMS”) and the Office of Inspector General (“OIG”) jointly issued a rule (the “Final Rule”) to finalize five (5) waivers of certain fraud and abuse...more
11/5/2015
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Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Civil Monetary Penalty ,
Federal Register ,
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Healthcare Fraud ,
Interim Rule ,
Kickbacks ,
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Medicare Shared Savings Program ,
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Shared Savings Program ,
Stark Law
On September 29, 2015, the Office of Inspector General (OIG) released two reports that reviewed the Office of Civil Rights’ (OCR) enforcement of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The...more
On September 2, 2015, the U.S. Department of Health and Human Services ("HHS") announced that it had entered into a Settlement Agreement with an Indiana-based medical practice for alleged violations of the Health Insurance...more
9/4/2015
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Compliance ,
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Cyber Attacks ,
Cybersecurity ,
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Health Care Providers ,
Health Insurance Portability and Accountability Act (HIPAA) ,
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Privacy Policy ,
Settlement Agreements
St. Elizabeth’s Medical Center (SEMC), a tertiary care hospital based in Brighton, Mass., agreed to pay $218,400 to address deficiencies in its HIPAA compliance activities. The SEMC settlement continues a pattern of...more
On June 25, 2015, the United States Supreme Court (the "Court"), in the high-profile decision of King v. Burwell, upheld the availability of tax credits under the Affordable Care Act ("ACA") for individuals purchasing health...more
6/29/2015
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Department of Homeland Security (DHS) ,
Health Insurance ,
Health Insurance Exchanges ,
Healthcare Reform ,
King v Burwell ,
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SCOTUS ,
State Health Insurance Exchanges ,
Subsidies ,
Tax Credits
On June 9, 2015, the Department of Health and Human Services Office of Inspector General (OIG) published a one-page fraud alert entitled, "Physician Compensation Arrangements May Result in Significant Liability." This is the...more
On May 14, 2015, four New Jersey legislators introduced the Out-of-Network Consumer Protection, Transparency, Cost Containment and Accountability Act (the "Legislation"). If enacted, the Legislation would increase health care...more
The Office of the National Coordinator for Health Information Technology (ONC-HIT) released version 2.0 of its Guide to Privacy and Security of Electronic Health Information (the Guide). While the Guide clearly states that it...more
On April 27, 2015, the U.S. Department of Health and Human Services (HHS) announced that Cornell Prescription Pharmacy (CPP), a single-location pharmacy in the Denver, Colo. metropolitan area, agreed to settle alleged HIPAA...more
On April 16, 2015, President Obama signed into law the Medicare Access and CHIP Reauthorization Act of 2015 ("the Act"). The national headlines about the Act’s passage focused on the repeal of the sustainable growth rate...more
On Tuesday, March 10, 2015, the U.S. Department of Health and Human Services ("HHS") announced the introduction of the Next Generation Accountable Care Organization ("ACO") Model of payment and care delivery. ACOs...more
On January 26, 2015, the U.S. Department of Health and Human Services ("HHS") announced the launch of the Better Care. Smarter Spending. Healthier People: Why it Matters initiative. According to HHS, this is the first time...more
2/2/2015
In a final rule published in the Federal Register on November 13, 2014, the Centers for Medicare and Medicaid Services (CMS) eliminated the federal Sunshine Act reporting exclusion for payments to physicians at continuing...more
The U.S. Department of Health and Human Services (HHS) Office of Civil Rights (OCR) announced on December 8, 2014 that a community behavioral health organization agreed to pay $150,000 and adopt a corrective action plan to...more
In early November 2014, the New Jersey Department of Health (DOH) sent a letter to every physician licensed by the New Jersey Board of Medical Examiners (BME) regarding New Jersey’s statutory requirement that every surgical...more
On October 17, 2014, the Centers for Medicare and Medicaid Services (CMS) and the U.S. Department of Health and Human Services, Office of Inspector General (OIG) published in the Federal Register (79 FR 62356 et seq) a notice...more
In the Friday, October 3, 2014 issue of the Federal Register (79 F.R. 59717 et. seq), the Department of Health and Human Services (“HHS”) Office of Inspector General (“OIG”) published a proposed rule (“Proposed Rule”) to...more
10/9/2014
There are two important updates with respect to the Health Insurance Portability and Accountability Act of 1996 (HIPAA). First, on September 17, 2014, the U.S. Department of Health and Human Services (HHS) issued guidance to...more
On August 15, 2014, the Centers for Medicare and Medicaid Services (CMS) re-opened the Open Payments system for physicians and teaching hospitals to register, review, and, if needed, dispute information gathered to date. CMS...more