Matthew Murer

Matthew Murer

Polsinelli

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HFS Issues Clarification on MMAI Program

On August 8, 2014, the Illinois Department of Healthcare and Family Services (HFS) issued a three-page memo to long term care nursing home providers clarifying several issues regarding participation in the Medicare/Medicaid...more

8/19/2014 - Long Term Care Facilities Long-Term Care MCOs Medicare-Medicaid Alignment Initiative

Health Reform + Related Health Policy News

Enrollment in Health Plans under ACA Exceeds Projected Number of 7 Million - The White House announced on April 1 that 7.1 million Americans had enrolled in health plans under the Affordable Care Act ("ACA"). ...more

4/28/2014 - Affordable Care Act Healthcare Reform HHS HIPAA Medicare Physician Medicare Reimbursements Risk Assessment Same-Sex Marriage

Health Reform + Related Health Policy News - April 2014

In This Issue: - Top News ..Sebelius: No More Health Law Delays; No Enrollment Extension ..CMS Announces Innovative Hospice Care Model - State News ..17 States and D.C. Implementing SHOP Health Insurance...more

4/4/2014 - CMS Health Insurance Exchanges Healthcare Reform HHS Medicaid Waiting Periods

Proceed With Caution: Contracts Between Senior Communities And Placement Agencies May Not Violate The Anti-Kickback Statute

In This Issue: - Background of the Arrangement - The OIG’s Analysis: How the Senior Communities Reduced Their Risk - What Providers Should Know - Excerpt from Background of the Arrangement: The...more

2/6/2014 - Anti-Kickback Statute Elder Care Elder Issues Nursing Homes OIG

Stolen Thumb Drive Sets HIPAA Precedent

A Massachusetts dermatology practice, Adult & Pediatric Dermatology, P.C. ("APDerm") recently agreed to pay $150,000 to settle potential violations of HIPAA Privacy, Security, and Breach Notification Rules. The settlement was...more

1/24/2014 - Data Breach Data Protection EHR HIPAA PHI Theft

Health Reform + Related Health Policy News - January 2014, Issue 1

In This Issue: - Top News ..Congress Approves Budget Deal with Short-Term ‘Doc Fix' ..CMS “Two-Midnight” Rule delayed until March 31, 2014 ..Individuals with Canceled Insurance Policies May Apply for...more

1/24/2014 - Affordable Care Act CMS EHR Exempt Organizations Healthcare Healthcare Fraud Healthcare Reform HHS HIPAA Hospitals Medicare Misbranding OCR OIG Prescription Drugs Tax Exemptions

Health Reform + Related Health Policy News - December 2013

In This Issue: - Top News ..CMS Releases Payment Rules for the Medicare Physician Fee Schedule, Hospital Outpatient Prospective Payment System, Renal Dialysis and Home Health ..President Signs the Drug Quality...more

12/17/2013 - CMS Drug Compounding FDA Health Insurance Exchanges Medicaid Medicare Pharmacies Physician Fee Schedule Stark Law

Health Reform + Related Health Policy News - November 2013 - Issue 1

In This Issue: - Top News ..HHS Gives Mixed Messages Regarding Federal Health Care Program-Status of Qualified Health Care Plans (QHPs) ..HHS Issues Health Insurance Marketplace Enrollment Report...more

11/25/2013 - Health Insurance Exchanges Healthcare HHS Open Enrollment Qualified Health Plans

Health Reform + Related Health Policy News - October 2013 - Issue 3

In This Issue: - Top News ..Deal to Raise Debt Ceiling, End Shutdown Yields No Major Changes to Health Care Law ..Problems with HealthCare.gov Website Continue; HHS Working to Fix Issues ..Kaiser Study...more

11/1/2013 - Abortion Affordable Care Act Debt Ceiling Fraud Government Shutdown Health Insurance Exchanges Healthcare Healthcare.gov HHS Insurers Medicaid Medical Devices OIG Premiums Subsidies

Health Reform + Related Health Policy News - October 2013

In This Issue: - Top News ..Judge Orders $237.4 Million Penalty Against Tuomey for Stark Law and False Claims Act Violations ..Glitches and Demand Lead to Marketplace Frustration ..HHS Delays Small...more

10/16/2013 - Affordable Care Act CMS False Claims Act FDA Health Insurance Exchanges Healthcare Healthcare Reform HHS Medicaid Medicaid Expansion Medicare Open Enrollment Pharmacies Physician Medicare Reimbursements Stark Law

Failure To Maintain Automatic Sprinkler Systems In Nursing Homes Now Leads To Survey Citations And More

As of August 13, 2013, all nursing homes participating in Medicare or Medicaid must have automatic sprinkler systems installed throughout the building. CMS first established the sprinkler requirement in a final rule published...more

9/26/2013 - CMS Healthcare Medicaid Medical Liability Medicare Nursing Homes Safety Precautions

Health Reform + Related Health Policy News - July 2013

In This Issue: - Top News ..Obama Administration Delays Employer Mandate One Year ..House Energy and Commerce Committee Releases Draft Legislation for SGR Fix ..CMS Proposes Payment Changes for Medicare...more

7/11/2013 - Affordable Care Act CMS Competitive Bidding Contraceptive Coverage Mandate Contraceptives Delays Drug Distribution FDA Healthcare Healthcare Reform HHS Home Health Care Medicaid Medical Devices Medicare OIG Over-the-Counter Sales Pay or Play Pharmaceutical Prescription Drugs

Health Reform + Related Health Policy News - June 2013

In This Issue: - Top News ..CMS Finalizes MLR Rule for Plans, Maintaining Application to Part D Sponsors ..Early State Filings Show Premium Reductions under ACA ..HHS Received More Than 830 Letters of...more

6/11/2013 - Abortion Affordable Care Act Anti-Kickback Statute CMS FDA Health Insurance Exchanges Healthcare HHS Medicaid Expansion Medicare Preexisting Conditions State Health Plans Wellness Programs

Health Reform + Related Health Policy News - May 2013

In This Issue: - Top News ..Tavenner Wins Senate Confirmation to Head CMS ..US Charges 89 in Nationwide Medicare Fraud Crackdown - State News ..Vermont Becomes Fourth State to Allow Physician-Assisted...more

5/30/2013 - Affordable Care Act CMS DOL Fraud Healthcare Medicaid Medical Loss Ratio Medicare OIG Physician-Assisted Suicide Prescription Drugs Supply Chain

Health Reform + Related Health Policy News - May 2013

In This Issue: - Top News ..HHS Releases Hospital Pricing Data in Transparency Effort; Results Show Significant Variation ..States Divided on Medicaid Expansion ..CMS Issues FY 2014 Proposed Rules for...more

5/13/2013 - CMS Contraceptives Health Insurance Exchanges HHS Hospice Hospitals Long-Term Care Medicaid Medicaid Expansion Nurses Proposed Regulation

PODs Beware: OIG Releases Special Fraud Alert

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

5/10/2013 - Anti-Kickback Statute Fraud OIG Physician-Owned Distributors

CMS Creates "Open Payments" Website For Reporting Under The Physician Payment Sunshine Act

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

4/18/2013 - CMS Physician Payments Sunshine Act Websites

Health Reform + Related Health Policy News Update - April 2013

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 - CMS Contraceptive Coverage Mandate False Claims Act Healthcare Hospitals IRS Medicaid Expansion Medicare Advantage Physician Payments Physicians Subcontractors Sunshine Act Supervision Sustainability

Physician Payment Sunshine Act Final Rule Released

In This Issue: - Interpretation and Clarification of Key Definitions ..Applicable Manufacturers ..Applicable GPOs ..Covered Drug, Device, Biological or Medical Supply ..Covered Recipients ...more

3/7/2013 - Affordable Care Act CMS Healthcare Manufacturers Medical Devices Pharmaceutical Physicians Sunshine Act

Illinois Jury Found Nursing Home Liable For $28.1 Million In Whistleblower Case Alleging Substandard Care And Resident Abuse

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

2/22/2013 - Elder Abuse False Claims Act Fraud Nursing Homes Penalties Quality of Care Standards Whistleblower Protection Policies Whistleblowers Worthless Services Claims

Breaking Down The HIPAA Rule Changes: Part 5 Of 5 - Changes To Patients' Rights Under The Final Rule

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

2/18/2013 - Covered Entities Electronic Medical Records Health Plan Disclosures HHS HIPAA HIPAA Omnibus Rule HITECH Patient Rights PHI

Breaking Down The HIPAA Rule Changes: Part 4 Of 5 - Uses And Disclosures Of PHI Under The Final Rule; Changes Related To...

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

2/13/2013 - Business Associates Covered Entities Fundraisers HHS HIPAA Omnibus Rule Marketing PHI

Breaking Down The HIPAA Rule Changes: Part 3 Of 5 Modifications To The Breach Notification Rule

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

2/11/2013 - Business Associates Covered Entities Data Breach HIPAA HIPAA Omnibus Rule HITECH Notice Requirements PHI

Health Reform + Related Health Policy News Update - February 6, 2013

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

2/7/2013 - CMS Competitive Bidding Contraceptive Coverage Mandate FDA GAO Health Insurance Exchanges HHS Medicaid Shared Responsibility Rule Sunshine Act

Breaking Down The HIPAA Rule Changes: Part 2 Of 5 - Changes Affecting Who Is A Business Associate And New Business Associate...

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

2/6/2013 - Business Associates Compliance Covered Entities HHS HIPAA HIPAA Omnibus Rule HITECH PHI Privacy Rule Subcontractors

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