News & Analysis as of

With a New Year Rolls in a New OIG Work Plan

Recently, the Office of Inspector General (OIG) of the Department of Health and Human Services (HHS) released its Work Plan for Fiscal Year 2015 (“Work Plan”). The OIG protects the integrity of HHS programs by identifying...more

Quirky Question #247, An Update on Wellness Programs

Question: Our company has been considering implementing financial incentives for employees to participate in biometric screening as part of an employee wellness program. Are there legal issues we should be...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

Health Care Update - November 2014 #2

In This Issue: - Smoother Open Enrollment Sets Stage for Shift in Congressional Focus - Implementation of the Affordable Care Act - Other Federal Regulatory Initiatives - Congressional...more

News from the Health Law Gurus™

News from the Health Law Gurus™ is a weekly summary of notable health law news from around the country with helpful links to related content. Check back every week for the latest health law news stories. HIPAA in the...more

Survive The Season With Our Open Enrollment Checklist

It’s that time of year again, when fall weather brings with it a host of legal obligations for plan sponsors running open enrollment. Here’s what you need to know to survive the season....more

News from the Health Law Gurus™

Chinese Hackers Infiltrate Health System Network Affecting 4.5 Million Individuals – Community Health Systems, Inc. (“CHS”) reported this week that the information of approximately 4.5 million individuals has been affected by...more

Health Update - July 2014

Avoiding the Regulatory Land Mines of Commercial ACOs - While providers are showing great interest in creating ACOs to participate in the Medicare Shared Savings Program (MSSP), they are showing even greater enthusiasm...more

Can You Link Insurance Premiums To Smoking?

Rocked by soaring costs, including skyrocketing increases in health insurance premiums, employers are desperate to manage, and hopefully limit, whatever costs they can. Many employers have begun to look to the lifestyle...more

Minimum Necessary and the Breach Standard

When the new HITECH rules came out OCR specifically said, “...uses or disclosures that impermissibly involve more than the minimum necessary information...may qualify as breaches.” But what exactly is the minimum necessary...more

The Waiting is the Hardest Part: Final Regulations on the PPACA’s 90-Day Waiting Period Released

On February 24, 2014, the Internal Revenue Service (IRS), the Employee Benefits Security Administration (EBSA) of the U.S. Department of Labor (DOL), and the U.S. Department of Health and Human Services (HHS) jointly released...more

Healthcare Legal News - February 2014 • Volume 4, Number 1

In This Issue: - CMS ISSUES FINAL RULE ON DIRECT ACCESS OF LAB TEST RESULTS BY PATIENTS: On February 3, 2014, the Centers for Medicare and Medicaid Services (CMS) released a final rule that permits patients or...more

Unprecedented HIPAA Fine May Mean Increased Scrutiny and Penalties

Triple-S Management Corp. (“Triple-S”), a Puerto Rico-based health insurer, has been fined $6.8 million by the Puerto Rico Health Insurance Administration (“PRHIA”) following a Health Insurance Portability and Accountability...more

New Wellness Program Rules for 2014

Employers continue to look for ways to manage the cost of employee health care coverage as they navigate the turbulent waters of healthcare reform, and wellness programs continue to be a popular strategy. However, adoption...more

WellPoint agrees to pay $1.7M in HIPAA penalties: what this tells you

The Department of Health and Human Services (HHS) Office for Civil Rights (OCR) has announced that WellPoint, Inc. agreed to pay $1.7 million to settle potential violations of the Health Insurance Portability and...more

The Impact of the Supreme Court’s DOMA Decision on Employee Benefit Plans — Some Certainty, Many Unanswered Questions

The regulation of marriage was historically presumed to be the exclusive domain of the states. Since 1996, however, the Defense of Marriage Act of 1996 (“DOMA”) changed this presumption in two important respects...more

Implications Of Same-Sex Marriage Decisions By U.S. Supreme Court For Employer-Sponsored Health And Welfare Benefit Plans

Two controversial cases involving same-sex marriage were decided on June 26, 2013 by the United States Supreme Court. ...more

HIPAA Healthcare Reform - Prompt Attention Needed to Address Upcoming 2013 Deadlines

2013 has already been a busy year for employers with group health plans who are trying to navigate the Affordable Care Act and its immediate implications for employee benefits. However, there are other, less talked about but...more

Well, Well, Well…Employee Wellness Program Rules Update

The Departments of Treasury, Labor and Health and Human Services jointly issued final regulations on June 3, 2013 addressing wellness programs under the Affordable Care Act (the “ACA”) and the HIPAA non-discrimination rules. ...more

The U.S. Supreme Court Rules Defense Of Marriage Act Unconstitutional: Significant Implications For Employee Benefit Plans

On June 26, 2013, in U.S. v. Windsor, the US Supreme Court held the federal Defense of Marriage Act (“DOMA”) unconstitutional as a violation of the right to liberty found in the due process clause of the 5th Amendment to the...more

Supreme Court’s DOMA Ruling: Employee Benefit Plan, Tax, and Employment Considerations

Court's holding makes federal benefits and tax advantages available to same-sex couples but raises further questions. On June 26, the U.S. Supreme Court issued its long-awaited decision in United States v. Windsor,...more

Insurance Coverage for Healthcare False Claims Act, Stark, and HIPAA/HITECH Government Investigations

Federal enforcement of False Claims Act (FCA), Stark anti-kickback, and HIPAA/HITECH claims against healthcare companies continues to rise rapidly. FCA recoveries by the U.S. Department of Justice (DOJ) exceeded $9.5 billion...more

New HIPAA Rules Regarding Genetic Information Affect Employers, Group Health Plans, Health Insurers and Healthcare Providers

Genetic Information Under HIPAA - While the final rule supplementing and modifying the Health Insurance Portability and Accountability Act (HIPAA) Privacy, Security, Breach Reporting and Enforcement Rules—78 Fed. Reg....more

Proposed Regulations Released on Contraceptive Coverage Exemption and Accommodation for Nonprofit Religious Employers

On January 30, the Departments of Treasury, Labor, and Health and Human Services (the “Departments”) released proposed regulations regarding contraceptive coverage for employees of religious employers. This guidance is the...more

Health Reform + Related Health Policy News Update: January 30, 2013

In This Issue: - Top News ..CMS, IRS Issue Proposed Rules on Health Insurance Mandate, Minimum - Essential Coverage ..Insurers Weigh Options for Exchange Participation ..Quality Improvements in Care...more

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