The Office of the Inspector General (OIG) released a Special Fraud Alert on March 26, 2013 warning that physician-owned distributorships (PODs) are "inherently suspect" under the Anti-Kickback Statute (AKS). Generally...more
On April 12, 2013, the Center for Medicare and Medicaid Services (“CMS”) created the “Open Payments” website where reported information under Section 6002 of the Affordable Care Act (“ACA”), commonly referred to as the...more
In this Issue:
- Top News
..Large Hospital Systems Settles for $25.5 Million for False Claims Act Allegations
..Catholics’ Challenge to Contraceptive Coverage Mandate Dismissed As Not Ripe
- States...more
4/17/2013
/ Centers for Medicare & Medicaid Services (CMS) ,
Contraceptive Coverage Mandate ,
False Claims Act (FCA) ,
Healthcare ,
Hospitals ,
IRS ,
Medicaid Expansion ,
Medicare Advantage ,
Physician Payments ,
Physicians ,
Subcontractors ,
Sunshine Act ,
Supervision ,
Sustainability
In This Issue:
- Interpretation and Clarification of Key Definitions
..Applicable Manufacturers
..Applicable GPOs
..Covered Drug, Device, Biological or Medical Supply
..Covered Recipients
...more
An Illinois district court jury in United States v. Momence Meadows Nursing Center, Inc. recently issued a verdict on February 11, 2013 imposing $28.1 million in civil penalties on the operators of a nursing home. The nursing...more
In This Issue:
- Right to Access Protected Health Information
- Restrictions on Health Plan Disclosures
- Guidance on How to Comply With the Expanded Patient Rights
..Evaluate Electronic Systems
..Revise...more
In This Issue:
- Modifications Related to the Use and Disclosure of PHI for Marketing Purposes
- Modifications Related to the Use and Disclosure of PHI for Research Purposes
..Compound Authorizations...more
In This Issue:
- Definition of “Unsecured Protected Health Information”
- Notice Requirements
- Action Items to Comply with the Breach Notification
- Excerpt from Definition of “Unsecured Protected Health...more
In This Issue:
- Top News
..CMS Announces Round 2 Competitive Bidding Single Payment Amounts
..CBO Lowers SGR Repeal Cost by $100 Billion
..Republicans Press HRSA on 340B Audits
..HHS Proposes...more
In This Issue:
- Expansion of, Clarifications to, and Explicit Inclusions in the Definition of BA
- BAs’ Direct Liability Under the Final Rule
- BAAs: Required Provisions Under the Final Rule and the Compliance...more
In This Issue:
- Brief Overview of Key Modifications in the Final Rule
- Suggested Action Items for Compliance with the Final Rule
..Covered Entities
..Business Associates
- Consequences of Noncompliance...more
2/1/2013
/ Business Associates ,
Compliance ,
Covered Entities ,
Data Breach ,
Department of Health and Human Services (HHS) ,
Enforcement ,
Health Insurance Portability and Accountability Act (HIPAA) ,
HITECH Act ,
Notice Requirements ,
PHI ,
Third-Party
In This Issue:
- Top News
..CMS, IRS Issue Proposed Rules on Health Insurance Mandate, Minimum
- Essential Coverage
..Insurers Weigh Options for Exchange Participation
..Quality Improvements in Care...more
In This E-Alert:
- Notable ATRA Provisions
- Medicare Extensions
- Other Health Provisions
- Other Health Extensions
- Excerpt from Notable ATRA Provisions:
Medicare Physician Payment Update...more
In This Issue:
- OMB Directs Department Heads to Prepare for Sequestration
- HHS Finalizes Omnibus HIPAA Rule, Enhances Privacy Requirements
- SCOTUS Says Equitable Tolling Not a Factor in DSH Case
- Report...more
1/25/2013
/ Data Protection ,
DSH ,
Equitable Tolling ,
Health Insurance Portability and Accountability Act (HIPAA) ,
HIPAA Omnibus Rule ,
HITECH Act ,
Hospitals ,
Medicaid ,
Medicare ,
OMB ,
Pay-For-Delay ,
Pharmaceutical Industry ,
SCOTUS ,
Sequestration
On January 17, 2013, the U.S. Department of Health and Human Services (HHS) issued an advance copy of the final omnibus rule which implements changes to the Health Insurance Portability and Accountability Act of 1996, and the...more
1/22/2013
/ Data Breach ,
Data Protection ,
Department of Health and Human Services (HHS) ,
Enforcement ,
GINA ,
Health Insurance Portability and Accountability Act (HIPAA) ,
HIPAA Omnibus Rule ,
HITECH Act ,
Notice Requirements ,
OCR ,
Privacy Policy
In This Issue:
- Fiscal Cliff Deal Lengthens Medicare Overpayment Recovery Period
- Cutting Medicaid Provider Tax May Shift Costs to States, CRS Finds
- MedPAC Finalizes Payment Recommendations, GAO Solicits...more
1/18/2013
/ American Taxpayer Relief Act ,
Centers for Disease Control and Prevention (CDC) ,
Centers for Medicare & Medicaid Services (CMS) ,
Fiscal Cliff ,
GAO ,
Medicaid ,
Medicare ,
MedPAC ,
OIG ,
Overpayment ,
SMART
In This Issue:
- CMS Releases FY 2012 Financial Report; Misses Target forReductions in Improper Payments
- CMS Releases Guidance on Medicaid/CHIP Issues
- HHS Secretary Extends Deadline for Decision on...more