News & Analysis as of

Midyear Check on Health Plan Compliance

If you sponsor or administer a group health plan, you are almost certainly taking steps to prepare for legal requirements that will become effective on or before January 1, 2015. New rules under HIPAA, the Affordable Care Act...more

Putting the Ethics Back into Healthcare Compliance

We all know someone who is a pest, a professional colleague, a friend or even a family member. I use the term affectionately and especially when I write postings that are restatements of obvious points....more

Healthcare Ethics and Compliance Program Requirements

The Affordable Care Act included a mandate that medical service providers and suppliers enact compliance programs as a condition of participating in federal health care programs. (The ACA also set a deadline of March 23,...more

For ACA, Check Your Handbooks and Intranet

If you are like most employers, you have been diligently revising your benefits plans and working with your insurance providers to make sure your Summary Plan Descriptions comply with the Affordable Care Act. After those...more

Meaningful Compliance Equals Sound Financial Management

In traditional finance parlance the term "risk management" involves identifying events that can have adverse financial consequences and then taking action to prevent and/or minimize the damage caused by these events. Thus...more

Health Law Insights Newsletter - May 2014

In this Issue: - Federal Updates - State Updates - HIPAA Updates Excerpt from Federal Updates: The Centers for Medicare & Medicaid Services (CMS) issued a final rule to reduce unnecessary or...more

Health Law Alert: HIPAA Enforcement on the Rise, as OCR Audit Program Moves Forward

A recent settlement from New York—involving the largest fine levied to date in the history of HIPAA enforcement, a staggering $4.8 million imposed on two public hospitals—should remind health care providers, health plans and...more

Perspectives - June 2014

In This Issue: - Staying in Compliance While Giving or Receiving Electronic Health Record Systems - When Donations Cross the Line - House Bill 296 Signed into Law to Increase Access to Epinephrine Autoinjectors...more

The Affordable Care Act—Countdown to Compliance for Employers, Week 30: The IRS Tells Us that Employer Payment Plans (Really,...

The IRS recently issued two Q&As on the subject of employer payment plans, the purpose of which was to again underscore that arrangements purporting to allow an employer to reimburse employees on a pre-tax basis for premiums...more

OIG Proposes Updates to Exclusion and CMP Authority

The Department of Health and Human Services, Office of Inspector General (OIG) recently issued a pair of proposed regulations to update its exclusion and civil monetary penalty (CMP) authority. The proposed regulations...more

The Affordable Care Act—Countdown to Compliance for Employers, Week 31: ERISA Section 510 and Limiting Employee Hours

In last week’s post, we examined the appropriateness of capping the annual hours of new “variable hour employees” as a way to limit exposure under the Affordable Care Act’s employer shared responsibility rules. (These rules...more

EARL e-News: USEPA To Review 100 Percent of Consent Decrees For Compliance - Updates on Environmental, Administrative and...

On April 10, 2014, USEPA released its 99-page Strategic Plan for Fiscal Year 2014 – 2018. As part of the Strategic Plan, USEPA set out its Mission is to protect human health and the environment. USEPA plans to accomplish its...more

The Affordable Care Act—Countdown to Compliance for Employers, Week 32: Why Capping Annual Hours at 1560 Does Not Work

Whenever Congress draws a line in the sand—such as with exposure for assessable payments under the Affordable Care Act’s employer shared responsibly rules—entities subject to regulation (here, applicable large employers) will...more

HHS OIG Releases Proposed Rules Regarding Increased Authority to Combat Fraud and Abuse under the ACA

The Office of Inspector General (OIG) of the Department of Health and Human Services proposed two new rules last week in order to expand its enforcement authority, implementing changes adopted as part of the Patient...more

Senate Bill No. 35: An Act Concerning Notice of Acquisitions, Joint Ventures and Affiliations of Group Medical Practices

At the end of the Connecticut General Assembly’s 2014 Regular Session, "An Act Concerning Notice of Acquisitions, Joint Ventures and Affiliations of Group Medical Practices" (the "Act") was passed and is awaiting the...more

Monthly Benefits Update

IRS Issues 2015 HSA Contribution Limits, High-Deductible Health Plan Definition, Out of Pocket Expense Limits - The Internal Revenue Service (IRS) issued guidance setting the inflation-adjusted amounts applicable to...more

Why Do I Need a Business Associate Agreement? Ensuring Your Business is HIPAA and HITECH Compliant

Many companies have recently begun receiving Business Associate Agreements from healthcare entities, including hospitals, clinics, physician offices, public health facilities and similar types of organizations. Business...more

Health Law Insights Newsletter - April 2014

In This Issue: - Federal Updates - State Updates - HIPAA Updates - Excerpt from Centers for Medicare & Medicaid Services Issues Guidance for Meaningful Use Hardship Exception: The Centers...more

Physical Therapy Provider Enters into HIPAA Settlement

U.S. Department of Health and Human Services Office for Civil Rights (OCR) recently announced yet another enforcement action. Specifically, OCR opened a compliance review of Concentra Health Services (Concentra) upon...more

The Affordable Care Act—Countdown to Compliance for Employers, Week 36: Hacking the Affordable Care Act’s $100/Day Penalties for...

Particularly with the issuance of final regulations under the Affordable Care Act’s employer shared responsibility rules, employers have been concerned—justifiably—with the pay-or-play penalties. ...more

Free HIPAA Help

Health care providers, health plans, business associates, and other entities affected by the federal HIPAA privacy and security regulations are quickly running out of excuses for not having a robust HIPAA compliance program...more

CMS Identifies Key Priorities for 2014 Compliance Reviews of Qualified Health Plans in the Federally Facilitated Marketplace

At a Centers for Medicare & Medicaid Services ("CMS") teleconference titled "Compliance Reviews in the Federally-Facilitated Marketplace" ("FFM"), which was held on April 10, 2014, CMS representatives discussed the agency's...more

Compliance Checkup: Does Your Company’s Retiree Medical Coverage Get a Passing Grade?

Does your company offer retiree medical coverage? This article highlights some of the common legal compliance issues we’ve noted recently when reviewing post-retirement medical coverage, and provides recommendations for...more

Do You Know What Your Hospital Board Members Are Doing?

David Chandler was appointed to serve as chairman of Tri-Lakes Medical Center (TLMC), a community hospital in Panola County, Mississippi. As chairman, Chandler set board meeting agendas, regularly dealt with the administrator...more

Hospital Executive Indicted for Allegedly Lying about Meaningful Use of Electronic Health Records

A hospital executive was recently indicted for allegedly submitting a false attestation regarding a hospital’s “meaningful use” of electronic health records (“EHR”) technology through the Medicare EHR incentive program. This...more

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