Health Care Providers

News & Analysis as of

Health Care Matters, Summer 2016

Special Masters in Health Care Antitrust Merger Cases: Resolving the Conflicting Interests - One of the most challenging aspects of antitrust cases in the health care field is the rich mixture of public interest...more

Locky Ransomware Continues to Hit Health Care Entities

FireEye Labs has reported that the Locky ransomware continues to hit the health care industry hard, and has increased in the month of August. Although the telecommunications, manufacturing and aerospace/defense...more

Agencies Encourage New Privacy Regulations to Close the mHealth Black Hole and Keep Pace with Evolving Technologies

On July 19, 2016, the ONC submitted a report to Congress which suggests that health privacy regulations soon may be revised to catch up with the universe of mHealth technologies that now use and share personal health data....more

Led by Texas, Several States Challenge Section 1557’s Gender Identity Protections in HHS’s Final Rule

On August 23, 2016, several States and three faith-based healthcare providers filed suit in the Northern District of Texas against the U.S. Department of Health and Human Services (“HHS”) over HHS’s interpretation of “sex” in...more

The Law Doesn’t Forbid Submitting False Claims

An Eighth Circuit decision provides a reminder that the False Claims Act doesn’t forbid submitting false claims: it forbids knowingly submitting false claims. That made all the difference in an appeal of summary judgment in...more

HHS Issues Final Non-Discrimination Rules for Healthcare Providers

Healthcare providers and others who receive federal financial assistance are now subject to new non-discrimination rules and notice requirements under the Affordable Care Act. The new regulation prohibits discrimination in...more

Hackers Steal 600K Records from Health Care Firms – Could Your Wearable Device Be Next?

Security firm InfoArmor published a report in late July 2016 stating that a group of attackers infiltrated American health care institutions, stole at least 600,000 patient records and attempted to sell more than 3 terabytes...more

Sixth Circuit Holds That Michigan Health Insurance Claims Assessment Act Falls Outside of ERISA’s Preemptive Reach

Whether state common law claims are preempted by the Employee Retirement Income Security Act of 1974 (ERISA) is a common issue in reimbursement disputes involving health care providers and insurance companies. In cases when...more

Nursing Facilities to Face Surveyors’ Review of Photo and Video Policies

The Centers for Medicare and Medicaid Services (CMS) this month took aim at the unauthorized taking and sharing of photos and videos – including through social media – in nursing facilities. In response to media reports and...more

CMS Flags Potential Provider “Steering” of Medicare/Medicaid Beneficiaries to Favorable ACA Marketplace Plans to Obtain Higher...

CMS is putting health care providers on notice that it considers it “inappropriate” for providers to offer premium or cost-sharing assistance to Medicare or Medicaid beneficiaries in order to “steer” the patient to an...more

Two New England States Pass Legislation Restricting Physician Non-Competes

We’ve written a lot this summer about the Massachusetts legislature’s latest failed attempt at non-compete reform. Two other states in New England, however, are able to claim accomplishments in that regard. Specifically,...more

Ransomware and Malware Continue to Plague Health Care Organizations

We continue to warn health care organizations about the real and serious risks associated with ransomware and malware, but organizations don’t prepare for it adequately and are getting hit hard. Just this past week,...more

Health Alert (Australia) August 22, 2016

In This Issue: - Judgments; Legislation; and Reports. - Excerpts from Judgments: Australian Capital Territory (ACT) 15 August 2016 Calvary Hospital Auxiliary Inc v D'Amico [2016] ACTCA 39 - The appellant,...more

EMTALA Plaintiff Trips Over State Law Requirement

If you bring a case in federal court alleging violation of federal law, you might assume that you needn’t be concerned with procedural requirements of state law. But you could be wrong. Just ask Cynthia...more

MACRA Physician-Focused Payment Model Technical Advisory Committee to Meet September 16

The Physician-Focused Payment Model Technical Advisory Committee will meet on September 16, 2016. ...more

Hold it, Doctor! Don’t Hit the Send Button!

The Joint Commission made a big splash when it issued its “Update: Texting Orders” back in the spring. That Update rescinded the accrediting organization’s long-standing prohibition on sending physician orders via text...more

CMS Cracks Down On Social Media Abuse By Nursing Home Staff

On August 5th the Centers for Medicare & Medicaid Services (CMS) issued a memorandum to all state survey agencies requiring that during the next standard survey of a nursing home, whether a Traditional or Quality Indicator...more

The Changing Landscape of FCA Litigation for Healthcare Providers Due to Increased Civil Penalty Amounts

Since the late 1990s, the False Claims Act (“FCA”) has heavily affected the healthcare industry. In 2015, two-thirds of FCA lawsuits targeted healthcare entities, which paid out $1.9 billion. However, it is likely that this...more

Section 1557 of the Affordable Care Act Requires Healthcare Providers to Take Certain Steps in 2016 to Promote Equity

Section 1557 of the Affordable Care Act aims to advance healthcare equity. This statutory provision provides that current non-discrimination laws, such as the Civil Rights Act of 1964, will now apply to individuals and...more

Get Off My Lawn (Or Gurney): Off Duty Employees Allowed To Picket on Hospital Employer’s Property

Seyfarth Synopsis: In a split decision, the NLRB ruled that off-duty employees of an acute care hospital had the right to picket the hospital’s main lobby entrance. After the collective bargaining agreement between acute...more

Managing the Transition to Transformation: Provider/Payor Integration: 2016 Is Not the 1990s

McDermott’s Managing the Transition to Transformation series is designed to help health systems and other health care industry leaders address the many challenges presented by the transformation in payment and care delivery...more

The Department of Justice Ups the Ante: Per Claim Penalties for False Claims Act and Anti-Kickback Statute Violations Nearly...

On June 30, 2016, the Department of Justice (“DOJ”) published an interim file rule that dramatically increases the per claim penalties for violations of the False Claims Act (“FCA”) and the Anti-Kickback Statute (“AKS”) among...more

Alabama CON Report

I. Certificate of Need Program - A. AL2016-023, RehabCare Group East, Inc., Birmingham, AL: Proposes to relocate the existing multi-service outpatient rehab center from 100 Shadow Wood Park, Ste. B, Birmingham, Shelby...more

The Potentially Dangerous Intersection of Healthcare and Social Media

Lately, there have been numerous reports in the media raising patient privacy concerns due to healthcare providers’ use of social media in the workplace. A few examples include...more

What’s In a Name? Or, the Importance of Emphasis

I.A. Khair of New Jersey ran an ambulance company called K&S Invalid Coach. Presumably, “Invalid” was pronounced IN-va-lid, with the emphasis on the first syllable. Maybe it should have been pronounced in-VAL-id, with the...more

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