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New York Enacts Out-Of-Network Transparency and Coverage Reform

Last month, a woman sued a health plan, claiming that she was intentionally misled about which physicians were participating providers in the company’s online health insurance exchange established under the Affordable Care...more

Changing Financial Landscape for Medical Debts of the Uninsured

The implementation of the ACA has afforded many with the opportunity to obtain insurance coverage. Despite the opportunity, a large number of individuals have either chosen not to enroll in a health plan or have been unable...more

FTC Commissioner Criticizes Proposed Legislation That Would Permit Health Providers to Negotiate Jointly with Health Insurers

In a February 26 speech before the Connecticut Bar Association, Federal Trade Commissioner Maureen Olhausen expressed strong opposition to proposed legislation that would create an antitrust exemption for collective...more

Belgium: Beware Of The Barking Privacy Watchdog, She’s Biting

The quietness in the privacy landscape in Belgium is about to drastically change. Reason for the change of pace are the recent major data breaches that were published by the media. The Privacy Commission announced it will...more

Health Insurer Fined Unprecedented $6.8 Million for HIPAA Violations

Federal fines for violations of the Health Insurance Portability and Accountability Act (HIPAA) may not exceed $1.5 million per incident per year. That's already a big number to think about — but employers also need to...more

Unique Data Breach Settlement – A Sign Of Things To Come?

A judge in the United States District Court for the Southern District of Florida has approved a $3 million data breach class action settlement agreement between AvMed, Inc. and plaintiffs. The settlement arises out of a...more

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

Health Update -- Dec 19, 2013

The Debate over Specialty Pharmaceuticals: Is the Promise Worth the Price? - ..What’s the Issue? - Specialty pharmaceuticals are a rapidly growing share of total drug expenditures by public and private health...more

Medical Identity Theft: New Recommendations By The California Attorney General To Health Care Organizations For Keeping Medical...

Unlike financial identity theft, which targets a victim’s financial health, medical identity theft threatens a victim’s very existence. The unauthorized access of a victim’s medical record not only grants the thief access to...more

Consumer Fraud Complaints Rise With Rollout of Affordable Care Act Exchanges

Criminal Prosecutions Expected in 2014 Related to ACA Fraud - Last month's troubled rollout of HealthCare.gov, the federal marketplace for online health insurance enrollment under the Affordable Care Act (ACA),...more

Interagency Initiative Targets Consumer Fraud in the ACA Exchange Marketplace

Yesterday, the Attorney General, the Secretary of the Department of Health and Human Services (HHS), and the Chairwoman of the Federal Trade Commission (FTC) announced an interagency initiative to prevent consumer fraud and...more

Regulations Affect Health Insurance Exchange Navigators, Mortgage Servicers

At both the federal and state levels, 2013 is proving to be a year of significant activity and regulatory changes for the insurance industry. Originally Published in TortSource - Summer 2013....more

Bringing Sunlight to Healthcare Pricing: The CMS Release of Hospital Charge Data

Former U.S. Supreme Court Justice Louis D. Brandeis once said that "Sunlight is the best disinfectant." The release of charges billed by some 3,337 Medicare hospitals for 100 of the most common inpatient diagnosis related...more

HHS Empowers Consumers to Know (and Enforce) their Rights Under HIPAA

The U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) published on its website a series of factsheets designed to educate consumers unfamiliar with their rights under the Health Insurance...more

OSHA Issues Interim Final Rule on PPACA Whistleblower Provision

On February 22, 2013, the federal Occupational Safety and Health Administration (OSHA) released an interim final rule concerning the whistleblower protection provisions of The Patient Protection and Affordable Care Act...more

OSHA Announces Whistleblower Protections Under The Affordable Care Act

The Affordable Care Act (ACA)'s whistleblower provisions may present a hazard for unsuspecting employers. On February 27, 2013, the Department of Labor's Occupational Safety and Health Administration (OSHA) released an...more

Special Edition: Health Law Update - February 28, 2013

In This Issue: - A Baker's Dozen of Significant Changes From the HIPAA/HITECH Rule 1. Business Associates and Subcontractors 2. Breach Notification 3. Covered Entity Organizational Structures 4. Cloud...more

OSHA Issues Interim Final Rule on Whistleblower Protections under the Affordable Care Act

As the 2014 implementation date for the most controversial provisions of the Affordable Care Act (ACA) draws closer, most businesses are focused on ensuring that their group health plans meet the ACA's requirements. But there...more

Too Big to Exclude; Too Much Wrongdoing to Ignore

A 2007 audit initiated by a Medicare Program Safeguard Contractor (PSC) discovered that a North Carolina provider had a high incidence of inpatient billings for patients who did not stay in the hospital overnight. The PSC's...more

South Carolina Court Holds No Coverage for Blast Fax Case Under E&O Policy

In its recent decision in BCS Ins. Co. v. Big Thyme Enters., 2013 U.S. Dist. LEXIS 20051 (D.S.C. Feb. 14, 2013), the United States District Court for the District of South Carolina had occasion to consider whether an alleged...more

HIPAA Omnibus Final Rule Imposes New Obligations on Business Associates

On January 25, 2013, the Department of Health and Human Services/Office for Civil Rights (HHS/OCR) published in the Federal Register (78 Fed. Reg. 5566) the long-awaited final rule titled Modifications to the HIPAA Privacy,...more

The Omnibus Final HIPAA Rule Is Here

On January 17, 2013, the Office of Civil Rights of the U.S. Department of Health and Human Services (HHS) announced the omnibus final rulemaking (Omnibus Rule). According to HHS, this Omnibus Rule is needed to strengthen...more

HHS Issues HIPAA/HITECH Omnibus Final Rule Ushering in Significant Changes to Existing Regulations

"Sweeping changes" is how Leon Rodriquez, of the Department of Health and Human Services Office of Civil Rights (OCR), characterized the effect of the final omnibus Health Insurance Portability and Accountability Act (HIPAA)...more

HHS Issues New HIPAA Rules

On January 17, the Department of Health and Human Services (HHS) issued a new rule under the Health Insurance Portability and Accountability Act (HIPAA). The omnibus rule is intended to enhance patient privacy protections,...more

New HIPAA Breach Notification Rule May Prove Costly for HIPAA-Covered Entities

On January 17, 2013, the U.S. Department of Health and Human Services (HHS) announced a final omnibus rule amending the Health Insurance Portability and Accountability Act of 1996 (HIPAA) in accordance with the HITECH Act of...more

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