Healthcare Professionals Dept. of Health and Human Services

News & Analysis as of

Manatt on Health Reform: Weekly Highlights - August 2015 #2

Reductions in uninsured rates are greatest in states with Medicaid expansions and State-based or State Partnership Marketplaces; Kentucky finds increased use of preventive healthcare following Medicaid expansion; and,...more

Health Care Update - August 2015 #2

Major Medicaid Drug Payment Rule Under OMB Review: Last week a highly anticipated rule that could set the standards for the Medicaid Drug Rebate program arrived at the White House for final review. The Medicaid Outpatient...more

OIG Issues Favorable Advisory Opinion of Hospital Leasing Arrangement

Last week, the Office of Inspector General (OIG) for the Department of Health and Human Services published Advisory Opinion 15-10 (Opinion). The Opinion addressed a hospital system’s proposal to lease non-clinician employees...more

Health Care Update - July 2015 #3

ACA Repeal Votes Continue: As part of a rare Senate Sunday session to consider a bill to replenish the highway trust fund for six years, Majority Leader Mitch McConnell (R-KY) brought up an amendment to repeal the ACA—in...more

OIG Recommends Improvements to Skilled Nursing Facility Billing Policies Regarding Changes in Therapy

The Department of Health and Human Services Office of Inspector General (OIG) recently issued a report that calls for CMS to accelerate its efforts to implement a new method for paying for changes in skilled nursing facility...more

Blog: Court Holds Corporate Integrity Agreement May Be Basis for Reverse False Claim Liability

This week, a federal district court denied Cephalon Inc.’s (Cephalon) motion to dismiss a third amended complaint filed under the False Claims Act (FCA) by three qui tam relators in United States ex rel. Boise v. Cephalon,...more

House Easily Passes 21st Century Cures Legislation, Includes Significant FDA Reforms

On July 10, 2015, the U.S. House of Representatives passed with an overwhelming majority (344-77), the 21st Century Cures bill (H.R. 6), a high-profile bipartisan bill intended to speed up and improve the process for...more

Warning From the HHS OIG: Physician Compensation Arrangements May Result in Significant Liability

The U.S. Department of Health and Human Services Office of Inspector General (the "OIG") recently issued a rare fraud alert warning physicians to ensure that their compensation arrangements, such as medical directorships,...more

Health Alert (Australia) - July 6, 2015

In This Issue: - Judgments; Legislation; and Reports. - Excerpt from Judgments: Victoria. 26 June 2015 - Northern Health v Kuipers [2015] VSCA 172 - The Victorian Supreme Court has allowed an appeal...more

OCR Enforcement Trends

On April 27, 2015, the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) announced a resolution agreement with Cornell Prescription Pharmacy (CPP) pursuant to which CPP paid a $125,000...more

MACRA’s Advancement of EHR Interoperability and Telehealth

This is the fourth and final post in our series on the Medicare Access and CHIP Reauthorization Act (MACRA). Pub.L. No. 114-10. We’ve previously covered the repeal of the Sustainable Growth Rate (SGR) in our April 20th post,...more

Skilled Nursing Facility Reaches Largest Failure of Care Settlement in DOJ History

On Friday October 10, 2014, the Department of Justice (DOJ) and the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) jointly announced a $38 million settlement with a skilled nursing facility...more

HHS releases new software for updating (but not replacing) HIPAA security risk assessment toolkits

Last week, the Department of Health and Human Services (HHS) released a new, free, downloadable tool to assist small and medium-size health care provider offices to conduct security risk assessments (SRA)....more

New HIPAA Tool Released by the Federal Government – Makes Assessing Risks Easier and It Won’t Cost You a Dime

Do you lie awake at night wondering if you or the health care entity for which you work is complying with the Health Insurance Portability and Accountability Act (“HIPAA”)? If so, you will be happy to hear that a good night’s...more

Paying the Price: Physician Group Faces Hefty Penalty and OCR Oversight After Failure to Conduct Security Risk Assessment and...

What you need to know: The Office for Civil Rights of the US Department of Health & Human Services is continuing its trend toward more aggressive enforcement of HIPAA violations. Small provider entities are not immune...more

NPDB Guidebook revision would clarify investigation reporting issues

Physicians always have been justifiably concerned about reports to the National Practitioner Data Bank (NPDB) regarding malpractice payments and adverse peer review actions. Two areas of frequent uncertainty have...more

Healthcare Provider Fees May Constitute Kickbacks Even Without Direct Referrals

In a recent advisory opinion, the Department of Health and Human Services inspector general warned health care providers about entering into contracts that may generate illegal kickbacks and result in administrative...more

A Detailed Analysis of Changes to HIPAA and the Implications for Healthcare Providers and Others in the Healthcare Industry: HIPAA...

Changes to the HIPAA Enforcement Rule - Background: On October 30, 2009, HHS issued an interim final rule revising the Enforcement Rule to incorporate provisions of the HITECH Act. The NPRM then proposed a number of...more

CLIENT ALERT: HHS Announces More Than $1 Million Each In Penalties For HIPAA Security Rule Violations

Businesses subject to HIPAA rules should take note of recent penalties imposed by the U.S. Department of Health and Human Services (“HHS”). Penalties of more than $1 million each were leveled as a result of Security Rule...more

OCR Issues Guidance On HIPAA Privacy Rule’s De-Identification Standard

On November 26, 2012, the Department of Health and Human Services Office for Civil Rights (“OCR”) published a thirty-two page document titled “Guidance Regarding Methods for De-identification of Protected Health Information...more

Utilizing the HIPAA audit protocols as a compliance tool By Kimberly J. Gold

Originally published in Compliance Today on December 1, 2012. ..Covered entities are now subject to privacy and security audits by OCR. ..OCR published audit protocols regarding its standards for such...more

Office of Civil Rights Releases Guidance on De-Identification of PHI Under HIPAA Privacy Rule

On November 26, 2012, the Department of Health and Human Services Office for Civil Rights (OCR) released long-overdue guidance on how covered entities subject to the Health Insurance Portability and Accountability Act (HIPAA)...more

OCR Issues Guidance on Methods for De-Identification of PHI Under HIPAA

On November 26th, the U.S. Department of Health and Human Services Office for Civil Rights (OCR) released guidance on the methods that covered entities and business associates can use to de-identify protected health...more

Guidance Regarding Methods for De-identification of Protected Health Information in Accordance with the Health Insurance...

The Department of Health and Human Services Office for Civil Rights released its long-awaited guidance regarding the de-identification of protected health information in compliance with the Health Insurance Portability and...more

HIPAA Privacy In The Aftermath Of Sandy: Be Prepared For The Next Emergency

As health care providers, patients, family members, friends, and disaster relief agencies such as the American Red Cross continue to grapple with the aftermath of Hurricane Sandy it is important to be mindful of privacy...more

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