Health Care Providers

News & Analysis as of

OIG Issues Revised Policy Statement Regarding Permissive Exclusion

On April 18, 2016, the Office of Inspector General of the United States Department of Health and Human Services (“OIG”) issued a revised policy statement containing the new criteria that OIG intends to use in implementing its...more

OIG Issues New Exclusion and CIA Guidance

On April 18, 2016, Inspector General Daniel R. Levinson announced the publication of updated guidance on how the Office of Inspector General (OIG) makes decisions about using its permissive exclusion authority and requiring...more

A&B Healthcare Week in Review

I. REGULATIONS, NOTICES, & GUIDANCE - On April 21, 2016, CMS issued a proposed rule entitled, “Medicare Program: FY 2017 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Requirements.” This...more

New HIPAA Phase 2 Audits: Targets Notified by Email Only

The U.S. Department of Health and Human Services Office for Civil Rights (OCR) recently announced the long-awaited launch of Phase 2 of its HIPAA Audit Program (Phase 2 Audits). The Phase 2 Audits will review the policies...more

Section 1557 of the ACA: The Legal Side of Health Equity

This week marks the end of National Minority Health Month and its 2016 theme of “Accelerating Health Equity for the Nation.” This month, the HHS Office of Minority Health’s goal was to “raise awareness of the health...more

New ACA, et. al. FAQs Cover Items From “Top” to “Bottom”

On April 20, the “Big Three” agencies (DOL, Treasury/IRS, and HHS) released another set of FAQs (the 31st, for those of you counting at home). Consistent with earlier FAQs, the new FAQs cover a broad range of items under the...more

New Law Aims to Ensure Updated and Accurate Physician Directories

An effort is underway to offer patients more accurate and complete provider information so that they may identify which providers are within their health plan and make educated decisions regarding treatment. On July 1, 2016,...more

Wyoming Medical Center victim of phishing scheme affecting 3,184 patients

Phishing incidents in February that may have compromised the data of 3,184 patients, including their names, dates of birth, medical record and account numbers, dates of service and medical information is causing Wyoming...more

Fourth Circuit Upholds Coverage Under CGL Policy for Data Breach Claims

The United States Court of Appeals for the Fourth Circuit (“Fourth Circuit”) recently concluded that an insurer had a duty to defend a health care company that was sued by individuals whose personal health information was...more

Tougher Oversight Needed on Harms of Medical Devices

Problems with medical devices contribute to 3,000 Americans’ deaths annually, research shows, and fixing any one of the problem devices can cost hundreds of millions. So why aren’t government officials doing more and better...more

Tennessee Legislature Passes Sweeping Changes to CON Law

On April 20, 2016, the Tennessee House and Senate completed final actions to pass legislation that makes significant modifications to the state’s certificate of need (CON) laws. The legislation, SB1842/HB1730 was sponsored by...more

Alabama CON Report

I. Certificate of Need Program - A. AL2016-008, EAMC Lanier, LLC, Valley, AL: Proposes to renovate a space for the conversion of seventeen (17) acute care beds to seventeen (17) inpatient rehabilitation beds, which was...more

Top Tips for OCR HIPAA Audit Preparation

The recently announced OCR HIPAA audits are not a cause for panic, according to experts, especially of organizations have proper documentation. With the most recent round of OCR HIPAA audits announced just last month,...more

Medical Non-Competes in Rhode Island: No Clean Bill of Health

The Rhode Island Superior Court recently refused to enforce a non-compete agreement against a local physician because it was against the public interest. Medicine and Long Term Care Associates, LLC v. Khurshid, PC 2015-0458,...more

There Is Such a Thing as Being Too Careful

According to The New York Times, Medicare may be punishing hospitals—and academic medical centers (AMCs) in particular—for being too careful. That’s how Northwestern Memorial Hospital’s chief medical officer sees the...more

Department of Health and Human Services Cracks Down on Vendor Oversight in Recent Hospital Settlements

From the rise in ransomware attacks to inadvertent disclosure of information by subcontractors, the health services industry is reminded that a potential consequence of a data breach is the threat of a regulatory enforcement...more

Rhode Island Trial Court Decision Could Spell Trouble for Employers Seeking to Enforce Restrictive Covenants Against Healthcare...

One of an employer’s first steps in a suit against a former employee to enforce a restrictive covenant is to seek a preliminary injunction to prevent the employee from continuing to violate his or her contractual obligations....more

Mississippi CON Report

I. Mississippi Certificate of Need Meetings During March 2016 - During the March 31, 2016, Certificate of Need meeting, Dr. Mary Currier, State Health Officer, concurred with the health and planning staff analysis and...more

A New Decision Under the False Claims Act Could be of Great Help to the Healthcare Industry

When it comes to the False Claims Act, the government usually wins, but a recent decision should provide the healthcare industry with a rare sigh of relief. The opinion in United States v. AseraCare Inc.1 acknowledges the...more

Passing on Healthcare Liability Claims Against Passive Investors in Tennessee

Tennessee recently enacted a law that limits who may be named as a defendant in a healthcare liability action. For causes arising on or after April 24, 2015, a healthcare liability action may only be brought “against the...more

CMS Announces Latest Alternative Payment Model - Comprehensive Primary Care Plus

Continuing in its efforts to promote alternative payment models, on April 11, 2016, CMS announced the Comprehensive Primary Care Plus (CPC+) model. CMS hopes to implement CPC+ in up to 20 regions, accommodating up to 5,000...more

Supreme Court Poised to Resolve Circuit Split on False Claims Act Liability Under Theory of Implied Certification

The U.S. Supreme Court is poised to resolve a circuit split over the False Claims Act (FCA) that could have broad implications for those that do business with the federal government. On April 19, 2016, the Supreme Court...more

Not a Check-the-Box Exercise: Failure to Have Signed BAA Results in Substantial Fine

A group practice that was the victim of a silver-harvesting scam has agreed to pay the U.S. Department of Health and Human Services (“HHS”) $750,000 to settle charges that it released protected health information (“PHI”) of...more

New report warns health care industry to expect more ransomware attacks

A new report of a survey of around 30 mid-sized hospitals by the Health Information Trust Alliance (HITRUST) concludes that health care entities should be prepared for an increase in ransomware attacks in the near future....more

OCR issues audit protocol and targets over 800 entities—business associates too

The Office for Civil Rights (OCR) has issued its revamped audit protocol for its second phase of auditing covered entities and business associates’ compliance with the HIPAA Privacy, Security and Breach Notification Rules....more

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