Insurance, Science, Computers & Technology, Health Law

OIG Revises Special Advisory Bulletin on Exclusions

by Howard Young | Morgan Lewis on 5/10/2013

OIG continues its aggressive interpretation of scope and effect of exclusion from participation in Federal health care programs and clarifies several open questions....more

PODs Beware: OIG Releases Special Fraud Alert

by Matthew Murer | Polsinelli on 5/10/2013

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

Checklist for Timely Compliance with HIPAA Omnibus Rule

by Lori Oliphant | Winstead PC on 5/7/2013

The deadline for compliance with the new HIPAA Omnibus Rule is looming for group health plans. As explained in a prior blog, stiff penalties may be imposed on employers whose plans fail to comply. Accordingly, employers...more

Supreme Court Denies Certiorari in MAO’s Double Damages Case

by Edward Waller | Fowler White Boggs P.A. on 5/3/2013

On April 15, 2013, the United States Supreme Court denied a petition for certiorari brought by GlaxoSmithKline (“Glaxo”) seeking review of a Third Circuit decision in favor of Humana Medical Plan (“Humana”), as a Medicare...more

HIPAA Task Force – May 2013

by Jennifer Spiegel Berman, Molly E. G. Ferraioli, Thora A. Johnson, Jessica Kuester, Peter Parvis | Venable LLP on 5/2/2013

In this issue: - What Your Business Needs To Do About Hipaa — Now - Action Items for Covered Entities and Business Associates (including Subcontractors) - Changes Impacting Business Associates (including...more

OCR Publishes HIPAA Guides for Providers and Consumers

by Kimberly J. Gold | Mintz Levin - Health Law on 5/2/2013

Understanding the complexities of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy and Security Rules is often a challenge for health care providers and consumers. Recognizing the widespread...more

Health Care Reform Implementation Update - April 26, 2013

by Mark Alderman | Cozen O'Connor on 4/26/2013

Marilyn Tavenner received bipartisan support from members of the Senate Committee on Finance in her confirmation hearing to lead the Centers for Medicare and Medicaid Services (CMS) though a full Senate vote is being held up,...more

CMS and OIG Propose Changes to the Electronic Health Records Exception and Safe Harbor

by Thompson Coburn LLP on 4/25/2013

On April 10, 2013, the Centers for Medicare & Medicaid Services (“CMS”) and the Department of Health and Human Services Office of Inspector General (“OIG”) published parallel proposed rules revising, respectively, the Stark...more

Health Care Reform Update -- April 22, 2013

by Joseph P. Hammang, Alexander Hecht, Jeremy Rabinovitz | Mintz Levin - Health Law on 4/23/2013

In This Issue: Implementation of the Affordable Care Act; Other HHS and Federal Regulatory Initiatives; Other Congressional and State Initiatives; Other Health Care News; and Hearings and Mark-Ups Scheduled. Excerpt...more

OIG Unveils Updated Self-Disclosure Protocol

by George Breen, Jason Christ, Anjali Downs, Jennifer Goodwin, David Matyas, Deepa Selvam, Carrie Valiant | Epstein Becker & Green, P.C. on 4/23/2013

In 1998, the Department of Health and Human Services' Office of Inspector General ("OIG") published the Self-Disclosure Protocol ("SDP"), which provides a mechanism through which health care providers may voluntarily report...more

OIG and CMS Issue Proposals to Extend Safe Harbor and Exception for EHR Donations

by Darby C. Allen, Donna S. Clark | BakerHostetler on 4/22/2013

In the April 10 Federal Register, two agencies within the U.S. Department of Health and Human Services published proposed rules that many healthcare providers have been anxiously awaiting affecting donations of electronic...more

OIG Updates Provider Self-Disclosure Protocol

by B. Scott McBride, Summer Swallow | BakerHostetler on 4/19/2013

On April 17, 2013, the U.S. Department of Health and Human Services Office of Inspector General (OIG) published a revised Provider Self-Disclosure Protocol (SDP) that clarifies the process for healthcare providers, suppliers...more

CMS and OIG Issue Proposed Rules Modifying the Stark Exception and Anti-Kickback Safe Harbor for Donation of EHR

by C. Frederick Geilfuss II, Shilpa Patel, Richard Rifenbark, Donald H. Romano | Foley & Lardner LLP on 4/19/2013

On April 10, 2013, the Centers for Medicare and Medicaid Services (CMS) and the Office of the Inspector General of the U.S. Department of Health and Human Services (OIG) each published proposed rules in the Federal Register...more

HHS Extends Sunset Date for Stark Exception and Anti-Kickback Safe Harbor for EHR Donations

by Daniel F. Gottlieb | McDermott Will & Emery on 4/19/2013

The Centers for Medicare & Medicaid Services and the U.S. Department of Health and Human Services issued proposed rules that would extend the sunset date for the Stark Law exception and the federal Anti-Kickback Statute safe...more

340B Drug Pricing Program: Recent Developments

by Elizabeth Elson, Anil Shankar | Foley & Lardner LLP on 4/19/2013

The 340B Drug Pricing Program (340B Program) continues to undergo a period of intense scrutiny and debate over how compliance with program rules is enforced. As previously reported in the May 30, 2012 edition of Foley’s Legal...more

Court Rules That Supervision and Enrollment Issues Don't Give Rise to False Claims Act Liability

by Kristen Cilento Carter | Ober|Kaler on 4/19/2013

Following the ever-growing progeny of cases holding that Medicare conditions of participation do not give rise to False Claims Act (FCA) liability, the United States Court of Appeals for the Sixth Circuit overturned an $11...more

HHS Office of Inspector General Issues Updated Self-Disclosure Protocol

by Ropes & Gray LLP on 4/19/2013

On April 17, 2013, the Office of Inspector General of the Department of Health and Human Services (“OIG”) released an Updated Provider Self-Disclosure Protocol (“SDP”). The Updated SDP replaces OIG’s original Provider...more

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

by Thomas Donohoe, Lauren Groebe, Lindsay Kessler, Matthew Murer | Polsinelli on 4/18/2013

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

Protections to Be Extended for Electronic Health Record Donations

by Heather Deixler, W. Reece Hirsch, Albert Shay, Howard Young | Morgan Lewis on 4/17/2013

CMS and OIG issue similar proposed rules to modify the electronic health record exception and safe harbor. On April 10, the Centers for Medicare & Medicaid Services (CMS) and the Office of Inspector General (OIG) of...more

2014 Final Call Letter: CMS Raises Medicare Advantage Rates but Foreshadows Other Significant Program Changes

by Roy M. Albert, Theresa C. Carnegie, Tara Swenson | Mintz Levin - Health Law on 4/17/2013

After receiving many comments on its Draft Call Letter, CMS published its Contract Year 2014 Final Call Letter on April 1, 2013. The Final Call Letter addresses a wide variety of issues that will affect all parties involved...more

CMS Officially Launches National Physician Payment Transparency Program Website

by Karen S. Lovitch, Kate Stewart | Mintz Levin - Health Law on 4/16/2013

The Centers for Medicare & Medicaid Services (“CMS”) recently launched the National Physician Payment Transparency Program: OPEN PAYMENTS website, which provides Sunshine Act compliance resources, including Fact Sheets and...more

CMS, OIG Propose to Extend EHR Stark Exception and Anti-Kickback Safe Harbor

by King & Spalding on 4/16/2013

On April 10, 2013, CMS and the HHS Office of Inspector General (OIG) each published proposed rules to extend the sunset dates for the Stark exception and anti-kickback statute safe harbor permitting donations of EHR software...more

OIG Proposes Amendments to the Electronic Health Records Safe Harbor

by Paul Koob, Dee Spagnuolo | Ballard Spahr LLP on 4/11/2013

The Office of the Inspector General (OIG) for the Department of Health and Human Services announced and solicited comments to proposed rule changes to the Electronic Health Records Safe Harbor (EHRSH) under the federal...more

CMS and OIG Propose Extension of Federal Stark Exception and Anti-Kickback Safe Harbor for Electronic Health Record Donations

by Ropes & Gray LLP on 4/11/2013

On Wednesday, April 10, 2013, the Centers for Medicare & Medicaid Services (“CMS”) and the Office of the Inspector General (“OIG”) of the Department of Health and Human Services published complementary proposed rules in the...more

Health Care Client Alert: OIG and CMS Propose Extensions and Modifications to Their EHR Anti-Kickback Safe Harbor & Physician...

by Sven Collins, Melodi Gates, Mimi Hu, Stephen Nash, Michi Tsuda | Patton Boggs LLP on 4/10/2013

On Monday April 8, 2013, the Department of Health and Human Services Office of Inspector General (OIG) and Centers for Medicare & Medicaid Services (CMS) released closely aligned proposed rules to extend their parallel...more

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