Healthcare

News & Analysis as of

CMS Releases CY 2015 ESRD PPS and DMEPOS Proposed Rule

On July 2, 2014, CMS released the CY 2015 End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) and Durable Medical Equipment Prosthetics, Orthotics, and Supplies (DMEPOS) Proposed Rule. ...more

CMS Releases Proposed HHA Rates for 2015 and Other Proposed Changes Affecting HHAs

On July 1, 2014, CMS released the proposed update to the Home Health Prospective Payment System (HH PPS) rates, which would apply to calendar year 2015 Medicare payments. ...more

New York Enacts Out-Of-Network Transparency and Coverage Reform

Last month, a woman sued a health plan, claiming that she was intentionally misled about which physicians were participating providers in the company’s online health insurance exchange established under the Affordable Care...more

Coming Soon To A (Computer) Screen Near You: Your Doctor

Both wellness visits and behavioral health visits would be added to the list of Medicare-covered telemedicine services. And it’s not just follow-up wellness visits that would be covered. Even initial visits qualify,...more

The Government Intervenes In False Claims Act Case Alleging Failure To Return Overpayments Within 60 Days

On June 27, 2014, the United States intervened in a qui tam action under the False Claims Act alleging that certain New York hospitals failed to refund Medicaid overpayments within 60 days of identifying them, as required by...more

Scorecard Ranks States on Long-Term Care Services

A new report ranks states on the quality and accessibility of their long-term care services and concludes there is a lot of room for improvement. The 2014 State Long-Term Services and Supports Scorecard finds that quality of...more

Patient Records: Increasing Exposure for Privacy Breaches

Healthcare providers and businesses that store or process protected health information ("PHI") face increased scrutiny and significant fines for data privacy breaches and security lapses in the coming months....more

Health Care Update - July 2014

In This Issue: - E&C continues to push for bipartisan efforts to improve drug pipeline - Implementation of the Affordable Care Act - Other Federal Regulatory Initiatives - Other Health Care...more

Personalized Medicine Today: PMC Issues Fourth State of the Industry Report

Personalized medicine is changing the paradigm of the research, development and delivery of health care. The Personalized Medicine Coalition (PMC), a consortium of interested stakeholders that seeks to promote the...more

CMS seeks to update payment rates and eligibility certification requirements in proposed rule for Medicare home health services

On July 7, the Centers for Medicare and Medicaid Services (CMS) published a proposed rule updating Medicare’s Home Health Prospective Payment System payment rates for 2015....more

The Final Regulations Clarify The Application Of Orientation Periods To The Affordable Care Act's 90-Day Waiting Period Rule

Earlier this year, proposed regulations pertaining to the 90-day waiting period provision of the Affordable Care Act (ACA) introduced the concept that employers may require new employees to complete a one-month “orientation...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

New Whistleblower Provisions Under the Affordable Care Act

A great deal of controversy and media attention has certainly surrounded the Affordable Care Act (ACA), both before and after its passage. However, little if any of that attention concerned the whistleblower provisions...more

Federal Court Finds That TCPA Plaintiff Consented To Debt Collection Calls by Providing Phone Number On Hospital Admission Form

On June 25, Judge Michael Anello of the Southern District of California granted summary judgment in favor of defendant Sharp Healthcare (“Sharp”) in Hudson v. Sharp Healthcare, 13cv1807-MMA, a purported class action alleging...more

eHealth closer with electronic health privacy rules

eHealth is closer to become a reality in Italy with the approval by the Italian Data Protection of the decree providing the requirements for electronic health records systems. We had already discussed in this post...more

Fair Share Fees Unconstitutional in the Public Sector? Not So Fast

The United States Supreme Court has been issuing employment-law related decisions like a boss over the past week or so. Many observers thought that the Court's decision in Harris v. Quinn, a case examining the...more

Supreme Court Rules Closely Held Businesses Shielded from Contraception Mandate

The U.S. Supreme Court on Monday created a new exemption to the Affordable Care Act (ACA) provision that requires for-profit companies to offer birth control health insurance coverage to their employees. In a 5-4 vote, the...more

Lab Arrangements under the Microscope: OIG Issues New Fraud Alert

Arrangements between laboratories and referring physicians/physician group practices (the “physicians”) have long been subject to scrutiny by the Department of Health and Human Services Office of Inspector General (“OIG”). On...more

New HIPAA Reports to Congress Shed Light on OCR Enforcement

The Department of Health and Human Services’ Office for Civil Rights (OCR) has issued two reports to Congress, as required by the HITECH Act. The compliance report details OCR’s enforcement activities for 2011 and 2012 and...more

Healthcare Legal News - July 2014 • Volume 4, Number 2

In This Issue: - DO SUBSIDIZED HEALTH CARE PLANS PURCHASED UNDER THE AFFORDABLE CARE ACT TRIGGER THE ANTI-KICKBACK STATUTE? The advent of federally subsidized private pay health insurance under the Affordable...more

Health Alert (Australia) - July 7, 2014

In This Issue: Judgments, Legislation, and Reports. Excerpt from Reports: Australia. Department of Health & Ageing Media releases ..3 July 2014 - Fighting mosquito-borne diseases in Queensland....more

Doing Business in Canada: Intellectual Property Protection

INTELLECTUAL PROPERTY PROTECTION - Effectively protecting a business’s intellectual property rights has become an increasingly important element of safeguarding the success of many businesses nowadays. The following is...more

Begin Preparing for Pennsylvania’s Enforcement of Act 122

The Pennsylvania Department of Health (“DOH”) Bureau of Laboratories (“Bureau”) recently announced that it will begin to phase-in enforcement of Act 122, which amended the Pennsylvania Clinical Laboratory Act (“Lab Act”),...more

Promises of Enhanced HIPAA Enforcement by HHS Illustrated by a Recent Record-Breaking Settlement Agreement and Increased Focus on...

An attorney from the Office for Civil Rights of the U.S. Department of Health and Human Services (HHS) recently disclosed that covered entities could face increased scrutiny for HIPAA violations in 2014. Specifically, the...more

High Rates of Unhealthy Enrollees in ACA Exchanges

Perhaps putting added pressure on insurers as they prepare to set rates for 2015, new evidence suggests that people enrolled in health plans under the Affordable Care Act have higher rates of serious health conditions than...more

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