Health Care Providers

News & Analysis as of

Eleventh Circuit Limits Scope of FCA Whistleblower Suit

Late last month, a three-judge panel of the Eleventh Circuit Court of Appeals reinstated portions of a former executive’s False Claims Act (“FCA”) whistleblower action against Health Management Associates Inc. (“HMA”),...more

Connecticut Supreme Court Issues Decision That Could Expand State Law Liability in Data Breach Class Actions for Businesses...

Health care providers have not escaped the recent proliferation of data breach class actions, but plaintiffs generally have been unsuccessful in bringing claims based on the Health Insurance Portability and Accountability Act...more

Meaningful Use Attestations - Be Careful of What You Attest To

Under the American Recovery and Reinvestment Act of 2009, eligible health providers who demonstrate “meaningful use” of certified electronic health record (EHR) technology can qualify for incentive payments under the Medicare...more

Health Law Pulse - November 2014

In This Issue: - Connecticut Supreme Court: HIPAA Does Not Preempt Negligence Claims - CMS Removes Continuing Education Exemption to Physician Payments Sunshine Act - Federal Government and New York...more

OIG's 2015 Work Plan Highlights Departmental Priorities

Each year the Department of Health and Human Services, Office of the Inspector General (OIG) issues its Work Plan to identify for the provider community the key fraud and abuse issues on which it will focus on in the coming...more

Telemedicine Technology: Tackling Rural Health Care Challenges

In honor of National Rural Health Day on November 20, it’s important to recognize the challenges — and opportunities — facing health care providers in delivering the highest quality care to rural populations. Our recent...more

Health Update - November 2014

“Healthcare-Related” Calls: Ambiguity at the Intersection of HIPAA and TCPA - Editor’s Note: The Federal Communications Commission (FCC) has established exemptions from certain requirements of the Telephone Consumer...more

Will Ebola Drive a New OSHA Infectious Disease Standard?

If asked, most safety directors, human resource professionals and others involved regularly with OSHA would probably cite construction as the industry most associated with employee injury and illness. Yet, according to OSHA...more

HHS Issues Special HIPAA Guidance for Ebola Outbreak

The U.S. Department of Health and Human Services ("HHS"), Office for Civil Rights ("OCR"), released a bulletin last week addressing how covered entities (including certain health care providers and employer group health...more

Government turns up the heat with the False Claims Act – 5 action steps for healthcare providers

Forbes magazine has dubbed 2014 “The Year of the Whistleblower.” For healthcare providers, this designation has translated into millions of dollars in fines and penalties and the initiation of criminal investigations. ...more

Court Affirms Costs against Plaintiffs Following Contentious Discovery (Pennsylvania)

Kuznyetsov v. West Penn Allegheny Health Sys., 2014 WL 5393182 (W.D. Penn. Oct. 23, 2014). In this Fair Labor Standards Act case, “[d]iscovery was contentious and the motions practice was excessive. As a result, a...more

DOJ Criminal Division Renews Efforts to Investigate Whistleblower Allegations

The Department of Justice (DOJ) has signaled a heightened effort to bring criminal prosecutors into the loop regarding False Claims Act referrals and other whistleblower complaints. In recent remarks at a conference comprised...more

Will the Mid-Term Elections Help Telemedicine Reimbursement?

Our recent survey of senior-level health care executives reinforced that lack of reimbursement remains the primary barrier to providers in adopting telemedicine services. Of our respondents, 41 percent indicated that their...more

Health Care Financing Trends: What Do They Foreshadow?

This article explores some current health care financing trends and speculates on what they may portend for work in a health care restructuring professional’s “pipeline.” While there are many kinds of health care enterprises...more

"U.S. v. Novartis: Reaffirming the Importance of Updating and Adhering to Corporate Policies"

A recent decision in a false claims act case, United States ex rel. Bilotta v. Novartis Pharmaceuticals Corporation (Novartis), underscores the importance of policing employee adherence to corporate policies and industry...more

Birmingham Medical News: Are You Ready for the Upcoming HIPAA Compliance Audits?

Earlier this year, the U.S. Department of Health and Human Services Office of Civil Rights ("OCR") announced its plan for a number of audits regarding compliance with the Health Insurance Portability and Accountability Act of...more

Connecticut Supreme Court Ruling Allows Private Plaintiff to Assert Negligence Claims Based on HIPAA

Recently, the Connecticut Supreme Court ruled that a plaintiff may assert state law negligence claims against a healthcare clinic that allegedly released confidential patient health data based on the Health Insurance...more

The Game Plan for Health Care Enforcement: Office of Inspector General Releases 2015 Work Plan

The Office of Inspector General (“OIG”) within the federal Department of Health and Human Services (“HHS”) is charged with protecting the integrity of HHS programs by combating fraud, abuse and waste. On Halloween of 2014,...more

Health Care Companies Beware: Prosecutors Focus on Conduct Alleged in FCA Lawsuits

On September 17, 2014, during a speech at the Taxpayers Against Fraud Education Fund Conference in Washington, D.C., Assistant Attorney General for the Criminal Division of the Department of Justice (DOJ) Leslie Caldwell...more

Connecticut Supreme Court Overturns HIPAA-Based Dismissal of State Law Privacy Claims

On Tuesday, November 4, 2014, the Connecticut Supreme Court announced its decision to overturn a trial court’s determination that a plaintiff could not bring state common law claims for negligence and negligent infliction of...more

Behavioral Managed Care Organizations Do Not Have Unbridled Discretion – Providers Have Rights

Here is a common scenario: A behavioral healthcare provider has committed substantial resources into developing specialized behavioral healthcare services in the counties managed by a Managed Care Organization (“MCO”) under...more

Responding to Subpoena for Medical Records May Create Liability for Healthcare Providers Under State Law Negligence Claims

Healthcare providers receiving a subpoena for patient medical records may want to think twice before complying with the subpoena and producing the records. A recent Connecticut case, Byrne v. Avery Center for Obstetrics and...more

A Recent State Supreme Court Ruling Opens the Door for Breach of Privacy Claims Against Health Care Providers

It has long been established that there was no private right of action with regard to HIPAA. All providers must be aware that state courts are beginning to turn the tide regarding such liability. On November 11, 2014, the...more

The New Promotional Rules: “There Are No New Promotional Rules”

There is resounding evidence that physicians and patients rely on the Internet—including social medial platforms—to research and communicate health information. FDA, however, has been slow to adapt even though the potential...more

Blog: CMS Explains New Data Matching and Resubmission Process During Open Payments Webinar Today

The Centers for Medicare and Medicaid Services (CMS) held a webinar today to address the process for correcting and resubmitting records that were removed from the Open Payments system in August 2014 by CMS due to data...more

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