Health Care Providers

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Three Factors Affecting the Mid-Level Practitioner Workforce, Part Two

In the last post, the subjects of collaborative agreements and autonomy were discussed in relation to how they affect mid-level practitioners. Today’s post now turns to how HRSA designation and limited services clinics will...more

Williams Mullen and Local Counsel, Bryan Davis, Win Declaratory Action Against HSD in New Mexico!!

For those of you who follow my blog, you know that the single state agency in New Mexico, Human Services Department (HSD), accused 15 behavioral health care providers, which made up 87% of the mental health care in NM, of...more

FTC and DOJ to Host Second Public Workshop on Health Care Competition

Last March, the Federal Trade Commission (FTC) and the Department of Justice (DOJ) began a public workshop series entitled, “Examining Health Care Competition.” On February 24 and 25, 2015, the FTC will physically host the...more

Summary Chart Of Proposed Amendments To 42 C.F.R. Part 425 Governing The Medicare Shared Savings Program

Mintz Levin has prepared a chart of the proposed amendments to 42 C.F.R. Part 425 governing the Medicare Shared Savings Program. This chart provides a summary of each proposed amendment and its potential impact....more

FTC Seeks Public Comments in Advance of Health Care Competition Workshop

The Federal Trade Commission and the Antitrust Division of the Department of Justice will co-host a second workshop in the series “Examining Health Care Competition” on February 24-25, 2015, in Washington, D.C....more

Ohio Proposes New Telehealth Prescribing Regulations

The Ohio State Medical Board has proposed new telehealth prescribing regulations, which are predicated upon whether the drug is a controlled or not a controlled substance....more

No Room at Nut Tree. But Why?

A pregnancy clinic that offers ultrasounds and counseling to expectant mothers signed a lease last October at the Nut Tree Road Medical Arts Center in Vacaville California. Alpha Pregnancy Clinics was looking for more square...more

CMS Announces Enforcement of EHR Payment Adjustments in 2015

On December 17, 2014, the Centers for Medicare and Medicaid Services ("CMS") announced that there would be reductions in Medicare reimbursement for health care providers who do not meet the CMS electronic health record...more

Catching Up on the False Claims Act

From a corporate risk perspective, if your company is in the financial industry, healthcare, or defense industry, your greatest legal and compliance risk has to be the False Claims Act....more

New Jersey Imposes New Encryption Standards for PHI

New Jersey recently amended its privacy laws to now require health insurers and care providers that do business in the state to encrypt PHI....more

Healthcare Fraud: Aggressive Enforcement Strategies

This week I am focusing on the persistent problem of healthcare fraud. For healthcare providers, the challenge of compliance and avoiding enforcement risks is particularly difficult. ...more

MedPAC Voices Concerns about Growing Volume, Burden of Medicare Quality Measures

In December 2014, CMS released a 329-page list of quality measures under consideration for the Medicare program. In a January 13, 2015 comment letter, MedPAC observes that volume of measures under consideration “reinforces...more

New state law mandates education about end-of-life treatment

Beginning in 2015, the newly enacted Medical Treatment Laws Information Act imposes educational requirements on Oklahoma health care providers related to patient end-of-life treatment decision-making. Two groups of...more

Ensuring Data Protection In The Implementation Of The EFPIA Disclosure Code: Key Challenges And How Pharmaceutical Companies Are...

The EFPIA Disclosure Code will, from 2016, require pharmaceutical companies to disclose details of payments and transfers of value made to healthcare professionals and healthcare organisations. The Code aims to promote,...more

The Supreme Court Hears Case Regarding Private Enforcement of the Medicaid Act Against States

On Tuesday, January 20, 2015, the U.S. Supreme Court will hear oral argument in a significant Medicaid-preemption case from the Ninth Circuit, Exceptional Child Center, Inc. v. Armstrong. In that case, Medicaid-participating...more

OIG Approves Nonprofit Foundation's Proposed Copayment Assistance Program

On January 5, 2015, the OIG posted a favorable advisory opinion, OIG Advisory Opinion 14-11, regarding a 501(c)(3) charitable foundation’s (Foundation) proposal to establish a patient assistance program that would provide...more

FTC Head Claims Antitrust Enforcement Supports Affordable Care Act

Edith Ramirez, head of the Federal Trade Commission (FTC), recently defended antitrust enforcement efforts in the healthcare industry against claims that such regulation undermines efforts to contain costs through provider...more

False Claims Act: 2014 Year In Review

In what is becoming an annual refrain, 2014 marked another year of robust False Claims Act (FCA) enforcement by the U.S. Department of Justice (DOJ) and mushrooming qui tam lawsuits by whistleblowers. Indeed, fiscal year 2014...more

CMS Announces 20 Repairs to RAC Program

Ever face the choice between trading in your old car or paying for multiple repairs? CMS faced that kind of choice with its Recovery Audit Contractor (RAC) program. Under the RAC program, contract auditors audit hospitals...more

2014 Review: The New York False Claims Act

There was significant activity in 2014 in matters involving the New York False Claims Act (NY FCA). This review summarizes the legislative activity, case law developments and noteworthy settlements in 2014....more

Health Care Enforcement in 2015: A Look Back on 2014 and Forecasting the Year Ahead

In testimony before the House Oversight and Government Reform Subcommittee on Health Care in April 2011, the now-pending nominee for U.S. Attorney General, Loretta E. Lynch, stated in no uncertain terms that “fighting health...more

The $10,000 Access Clause

This paragraph (or some variation) finds its way into lots of contracts when one or both of the parties to the contract are participants in the health care industry...more

California Insurance Commissioner Issues Emergency Regulations Affecting Narrow Provider Networks

On January 5, 2015, Commissioner Dave Jones issued emergency regulations affecting health insurers with respect to access to provider networks in response to consumer complaints that appointments with physicians are hard to...more

Telehealth, Health IT, and mHealth Policy: Considerations for Stakeholders

In recent months, as the conversation about reforming the health care system has shifted from websites and coverage expansion to achieving greater delivery system efficiencies, cost containment, and quality improvement, the...more

Government’s Health Care Fraud “Cash Cow” Keeps Mooing  [Video]

Jan. 9, 2015 (Mimesis Law) -- The U.S. government has changed up its approach to criminal health care fraud prosecutions, joining forces with fiscal intermediaries on the civil side to ramp up investigations, and this new...more

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