Health Updates

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OIG Reports Limited Compliance with Face-to-Face Certification Requirement for Home Health

The OIG recently released a report summarizing the details of its study regarding compliance with the requirement that physicians (or certain practitioners working with them) who certify beneficiaries as eligible for Medicare...more

Minimum Necessary and the Breach Standard

When the new HITECH rules came out OCR specifically said, “...uses or disclosures that impermissibly involve more than the minimum necessary information...may qualify as breaches.” But what exactly is the minimum necessary...more

South Carolina Legislative Update - April 2014

South Carolina General Assembly - The S.C. House and Senate are on furlough for the remainder of this week and will return on April 29. The House Judiciary Constitutional Laws Subcommittee on Ethics Reform will meet...more

Legal and Ethical Risks of Healthcare Businesses in China

Recent disputes and controversies involving Chinese subsidiaries of foreign pharmaceutical companies have sounded warning bells on legal and ethical issues regarding participation in China’s rapidly growing and evolving...more

Health Care Update

In This Issue: - Implementation of the Affordable Care Act - Other Federal Regulatory Initiatives - Other Congressional and State Initiatives - Other Health Care News - Upcoming Hearings and...more

Treating Mental Illness? Special Privacy Considerations Apply to Healthcare Providers

Decisions and unresolved questions about when and how to share information about mental illness treatment continue to make headlines. A variety of groups, including health care providers, law enforcement and mental health...more

The Affordable Care Act—Countdown to Compliance for Employers, Week 36: Hacking the Affordable Care Act’s $100/Day Penalties for...

Particularly with the issuance of final regulations under the Affordable Care Act’s employer shared responsibility rules, employers have been concerned—justifiably—with the pay-or-play penalties. ...more

Omnibus Health Care Bill (aka House Health Care Train)

The House Health & Human Services Committee passed House Bill 7113 by Representative Jason Brodeur (R-Sanford) after adopting a strike all amendment that includes provisions on health care topics previously addressed in...more

Expect Focus On Antitrust Issues In The Health Care Industry

There have been a number of high profile antitrust cases brought against health care providers, and the increasing interest of both the Federal Trade Commission (FTC) and plaintiffs should be considered in any proposed...more

The Fines They Are A-Changin’: New Regulations Herald Increased Fines For California Hospitals

As of April 1, 2014, California hospitals are subject to a significantly increased risk of being fined when state authorities find deficiencies in their compliance with licensing requirements and other health care-related...more

OIG Recommends Reduction in Hospital Outpatient Rates for Certain Procedures that Can Be Performed in ASCs

On April 16, 2014, the OIG released a report concluding that between CYs 2007 through 2011, Medicare has saved nearly $7 billion by covering surgical procedures in ASCs. In addition to the savings that would continue to...more

New Data Shows Higher Healthcare Costs in Second Half of 2013 – Is this A Result of the Affordable Care Act?

Will insurance expansion and industry consolidation result in higher healthcare costs, at least in the short term, and further stress the economy and the healthcare industry? That highly political question is being asked now...more

OCR Announces the Results from it's Pilot Audit and it's Plans For Next Year

The Office of Civil Rights Audit Pilot Program has come to an end with 115 audits, primarily in person, having been completed. The Pilot Program had multiple revelations in privacy, some of which were probably, not so...more

Health Care Reform Implementation Update - April 21, 2014

On April 14, the Congressional Budget Office (CBO) and the Joint Committee on Taxation (JCT) reported their findings that show a smaller rise in insurance premium costs under the Affordable Care Act (ACA) than previously...more

Obama Announces Affordable Care Act Enrollment Crosses the 8 Million Mark

Late last week, President Obama announced that more than 8 million had people signed up for health insurance under the Affordable Care Act. According to the White House, 35 percent of those that obtained insurance are under...more

Miami Proactively Seeking Medical Tourism

Though the multi-billion dollar medical tourism industry is dominated by Asia, it is on the rise in the United States, with many wealthy international patients eyeing the U.S.’s innovative treatments in areas such as...more

FDA Releases FDASIA Health IT Report

On April 3, 2014, the Food and Drug Administration (FDA) released the FDASIA Health IT Report (Report). This Report fulfills Section 618 of the Food and Drug Administration Safety and Innovation Act (FDASIA), Public Law...more

Health Care Reform: Employer Reporting Requirements

Health care reform imposed new employer reporting requirements regarding health coverage provided to individuals, including: (i) reporting of minimum essential coverage for employer-sponsored self-insured plans and (ii)...more

Recommendations for NextGen Health IT Infrastructure

Health care information technology (health IT) facilitates the delivery of personalized medicine by providing and supporting the infrastructure for patients, consumers and health care providers to communicate and distribute...more

Under The Dome: Inside The Maine State House 4-18-14

Under the Dome: Inside the Maine State House provides a high-level overview of recent activity at the Maine State House. Legislature Completes Last Full Week of Work for the Year - On April 18th at 1:05 a.m.,...more

HIPAA Impaired Providers and the ER - What Happens When Your Employee Becomes Your Patient?

I was speaking this week at IAHIMA’s Annual Conference on the issues relating to HIPAA audits and recent updates from OCR and ONC. As part of my program we typically solicit questions prior to the presentation, most of which...more

Labor & Employment E-Note - April 17, 2014

In This Issue: - Employers Face Increasing Number of Religious Bias Suits - Small Business Owners Concerned About Overtime Pay Requirements - Rising Number of Wage Theft Lawsuits Highlight Enforcement Issues -...more

Manatt on Medicaid: The Numbers

Even as the news media tries to untangle the latest data on Marketplace enrollment, an equally important and still-evolving story is playing out on the Medicaid side of the open enrollment equation. According to a Centers for...more

What Has Fahlen Wrought?

The California Supreme Court's decision in Fahlen v. Sutter Central Valley Hospitals has confirmed (not created) a sea change in the relations between hospitals and their medical staffs on the one hand, and physicians on such...more

South Carolina Legislative Update

South Carolina General Assembly - The South Carolina House of Representatives will be on furlough for two weeks and the Senate is only meeting Tuesday and Wednesday, April 15-16, and then off the following week....more

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