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If It’s Broken, Fix It (At Least Temporarily): New “Doc Fix” Law Prevents Automatic Medicare Pay Cuts to Physicians

Were you worried that your physician pay rate would plummet come March 31 due to Medicare’s sustainable growth rate (“SGR”) formula? You can stop pulling out your hair, at least until next year. On April 1, 2014, President...more

4/11/2014 - Healthcare Healthcare Reform Medicare Physician SGR Formula

New HIPAA Tool Released by the Federal Government – Makes Assessing Risks Easier and It Won’t Cost You a Dime

Do you lie awake at night wondering if you or the health care entity for which you work is complying with the Health Insurance Portability and Accountability Act (“HIPAA”)? If so, you will be happy to hear that a good night’s...more

4/11/2014 - Data Protection Electronic Medical Records Healthcare Professionals HHS HIPAA Security Risk Assessments

I’ll Be Watching You: Medicare Billing Info on over 880,000 Providers Released by CMS to Improve Transparency

Every payment you take, every claim you make, someone will be watching you. No, we don’t mean Sting. We mean all the consumers and businesses that will have greater access to physician billing information now because today...more

4/10/2014 - CMS Healthcare Medicare Medicare Part B Transparency

It’s Not Too Late: You May Still Qualify for ACA Coverage

March 31 was the last day to enroll in a health insurance plan through the federally-facilitated health care exchange. However, like many other Affordable Care Act (“ACA”) deadlines, the March deadline was a soft deadline, as...more

4/8/2014 - Affordable Care Act CMS Extensions Health Insurance Healthcare.gov Open Enrollment

Counties Beware – Your Governmental Status Does Not Protect You from Liability for a HIPAA Breach

As a county government, you may think that you have the protection of sovereign immunity and protection from other governments penalizing you. Your status does not protect you. The Department of Health and Human Services...more

3/21/2014 - Data Breach Data Protection Governmental Liability Healthcare HHS HIPAA

HHS to Health Insurers: Same Treatment for Same-Sex Couples

A release and a blog post from the Department of Health and Human Services (“HHS”) on Friday announced that starting in 2015, health insurance companies will be required to offer coverage to same-sex spouses if they offer...more

3/19/2014 - Affordable Care Act Discrimination Health Insurance HHS Preexisting Conditions Same-Sex Marriage

March 31: ACA Deadline or Just Another Monday?

March 31, 2014 is the open enrollment deadline for individuals who want to buy health insurance through the Health Insurance Marketplace (also known as the “Exchange”). Or is it?...more

3/19/2014 - Affordable Care Act Health Insurance Health Insurance Exchanges HHS

Seeing Dollar Signs: U.S. Settles with Ophthalmologist for $1.4 Million to Resolve FCA Claims

Last week, the United States settled with a Baltimore ophthalmologist for alleged violations of the False Claims Act (“FCA”). Pursuant to the settlement, the ophthalmologist, Dr. John Arthur Kiely, agreed to pay $1.4 million...more

3/18/2014 - False Claims Act Healthcare Healthcare Fraud Medicaid Medicare

As Simple as Do-Re-Mi: Treasury and IRS Issue Final Rules on Employer Information Reporting under ACA

While no one would claim that understanding the Affordable Care Act (“ACA”) and all of its associated regulations is as simple as the chorus from a Jackson 5 song, the Treasury and the Internal Revenue Service announced final...more

3/7/2014 - Affordable Care Act IRS Reporting Requirements U.S. Treasury

Oh, What a Shock! Provisions of the ACA Delayed Again

In a move that will not come as a surprise to anyone who has been following the rocky implementation of the Affordable Care Act (“ACA”), the Obama Administration has yet again delayed important provisions of the ACA. In a...more

3/7/2014 - Affordable Care Act Delays Employee Benefits Employer Mandates Healthcare Healthcare Reform Pay or Play Shared Responsibility Rule

Triple-S Socked with $6.8 Million Sanctions for PHI Breach

Triple-S, an insurance holding company and subsidiary of Triple-S Management Corporation, was notified by the Puerto Rican Health Insurance Administration (“HIA”) that HIA would pursue penalties against Triple-S for its...more

2/28/2014 - Data Breach Data Protection EHR Electronically Stored Information PHI

Do You Want Health Insurance with Your Entrée?

The Los Angeles Times is reporting that restaurant-goers are paying more than just tax and tip when dining out—a new policy at an L.A. restaurant means that diners will also be contributing to covering the cost of the...more

2/21/2014 - Affordable Care Act Employer Mandates Health Insurance Hospitality Industry Restaurant Industry

Lab Results on Demand: CLIA/HIPAA Amendment Increases Patient Access

A new final rule (the “Final Rule”) from the Centers for Medicare and Medicaid Services, the Centers for Disease Control and Prevention, and the Office for Civil Rights (collectively, the “Agencies”) gives patients and their...more

2/20/2014 - CLIA Clinical Laboratories CMS Final Rules HIPAA Kathleen Sebelius

Stick to Flowers on Valentine’s Day: Nurse Sends STD Diagnosis to Patient’s Girlfriend

John Doe is out-of-luck for a romantic Valentine’s Day this year. He recently discovered that his protected health information regarding treatment for a sexually transmitted disease (“STD”) was sent to his girlfriend. ...more

2/14/2014 - Healthcare Invasion of Privacy PHI

ACA Employer Mandate Delayed until 2016 for Mid-Sized Employers

Employers with 50 to 99 full-time employees will not be subject to penalties under the Employer Mandate of the Affordable Care Act (“ACA”) for failing to provide health insurance coverage to employees in 2015. On Monday, the...more

2/12/2014 - Affordable Care Act Delays Employee Benefits Employer Mandates Healthcare

Will Your New Gold, Silver, or Bronze Health Plan Cover Your Care if You Travel to Sochi for the Winter Olympic Games?

Snowboarders flying down halfpipes. Bobsledders careening down tracks. Goalies making glove saves. Those are just a few of the spectacles to be seen at the 22nd Winter Olympic Games. Despite all the pomp and circumstance...more

2/10/2014 - Employee Benefits Healthcare Olympics Travel

Judge’s Antitrust Decision Makes Hospitals Think Twice before Acquiring Physician Practices

A federal judge recently reversed a hospital system’s acquisition of a physician practice under antitrust laws. Judge B. Lynn Winmill of the United States District Court for Idaho ruled that St. Luke’s Health System, Ltd....more

2/7/2014 - Acquisitions Antitrust Litigation Healthcare Hospitals The Clayton Act

Advisory Opinion 14-01: OIG Says No AKS Sanctions for Senior Communities that Compensate Referral Source

In its first Advisory Opinion of 2014, the Department of Health and Human Services Office of Inspector General (“OIG”) found that an arrangement between a placement agency (the “Placement Agency”) and certain senior...more

2/5/2014 - Anti-Kickback Statute Nursing Homes OIG Referral Fees

ICD-10 Compliance Deadline is October 1, 2014—Philadelphia Office of CMS to Offer Webinars to Ease Transition

ICD-9 diagnosis and inpatient procedure codes will make way for ICD-10 codes starting October 1, 2014. Health care entities and providers need to be ready to make the switch if they want to receive reimbursement for claims....more

2/3/2014 - Compliance Deadlines Healthcare Reimbursements

Health Care Technology Trends for 2014: An Interview with Joseph Coyne, President of Information Technology Services and CIO at...

What’s the best way to provide quality patient care and reduce readmissions while lowering costs? Joseph Coyne, the President of Information Technology Services and Chief Information Officer at Continuum Health Alliance, LLC...more

1/31/2014 - Cloud Computing Data Protection EHR Healthcare PHI

Health Care Entity Pays $150,000 to HHS as a Result of Stolen Thumb Drive Containing PHI

Encrypting USB drives, analyzing security risks, and implementing breach notification policies and procedures could mean the difference between compliance with the Health Insurance Portability and Accountability Act (“HIPAA”)...more

1/29/2014 - Breach Notification Rule Data Breach EHR Healthcare HHS HIPAA PHI

Health Insurance Exchange Enrollees Now Eligible to Receive Benefits – Providers Should Be Ready To Verify Patients’ Health...

Beginning January 1, 2014, Americans who purchased a health insurance plan through the Health Insurance Marketplace (often referred to as the “Exchange”) on or before December 24, 2013 are now covered by those plans. Health...more

1/16/2014 - Affordable Care Act CMS Health Insurance Exchanges Healthcare Healthcare Reform Verification Requirements

Federal Government Extends Donated EHR Technology Protections under Stark and AKS through 2021

Some of the most important protections under the federal Stark Law (“Stark”) and the federal Anti-Kickback Statute (“AKS”) have been those that permit hospitals and other organizations to donate electronic health records...more

1/8/2014 - Anti-Kickback Statute CMS EHR Healthcare Hospitals OIG PHI Stark Law

Federal Government Announces Relief from Individual Mandate

Individuals who had their insurance plans cancelled and cannot find other insurance will be breathing a collective sigh of relief. A recent announcement from the Obama Administration states that such individuals will not be...more

1/7/2014 - Affordable Care Act Healthcare Healthcare Reform Individual Mandate

Deadline to Enroll in Health Insurance Coverage Extended through December 24

Along with stocking stuffers and gifts, last-minute Christmas shoppers have another item to put on their list: another chance to purchase health insurance coverage through the Federal Insurance Exchange. The Obama...more

12/24/2013 - Affordable Care Act Deadlines Health Insurance Exchanges Healthcare Open Enrollment

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