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Hospital CEO Jailed for Conspiracy to Violate AKS

The U.S. Department of Justice announced on January 15 that Jeffrey Paul Madison, the former chief executive officer of a Texas hospital, was sentenced to 36 months in federal prison for conspiring to violate the federal...more

Million Dollar Penalty Imposed on Pain Management Practice Following HIPAA Breach

The U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) announced on December 3 that it imposed a $1.19 million penalty on Gulf Coast Pain Consultants, a pain management practice in Florida, following...more

OCR Imposes $240,000 Penalty in HIPAA Ransomware Investigation

The U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) imposed a $240,000 civil monetary penalty against Providence Medical Institute in connection with a ransomware attack that revealed...more

New Consumer Protection Laws to Affect NY Healthcare Providers

On October 20, 2024, several significant consumer protection laws will go into effect, directly affecting healthcare providers throughout New York State. Introduced through the FY 2025 Executive Budget, these new laws reshape...more

Medical Provider to Pay $115,200 Penalty for HIPAA Right of Access Violation

The U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) recently announced that it ordered American Medical Response (AMR) to pay a civil monetary penalty of $115,200 for failing to comply with the...more

CT New Law Alert: Medical Debt Cannot be Reported to Credit Agencies

Connecticut Governor Ned Lamont recently signed a new bill into law that prohibits healthcare providers from reporting patients’ medical debt to credit rating agencies. The law goes into effect on July 1, 2024. In addition,...more

Federal Rules Limit “Junk” Health Plans

On March 28, the U.S. Departments of Health and Human Services, Labor and the Treasury collectively issued final rules with respect to short-term and limited duration insurance (STLDI) plans in an effort to reduce healthcare...more

Health Network Pays $345 Million for Compensating Physicians Above FMV

Community Health Network, Inc., based in Indianapolis, Indiana, has paid $345 million to settle alleged violations of the False Claims Act (FCA). The lawsuit was initiated through a whistleblower complaint that was filed in...more

Neurosurgeon Settles FCA Allegations for $825,000

The U.S. Department of Justice (DOJ) recently announced a settlement with a Missouri neurosurgeon and his fiancée regarding alleged violations of the False Claims Act (FCA) and Anti-Kickback Statute (AKS). The parties agreed...more

Arizona Hospital Pays $1.25 Million in HIPAA Settlement After Cyber Attack

The U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) announced on February 2 that Banner Health, a not-for-profit hospital system based in Arizona, has paid $1.25 million in order to settle alleged...more

OIG Advisory Opinion Promotes Hospital Use of NPs

The U.S. Department of Health and Human Services’ Office of Inspector General (OIG) recently issued a favorable Advisory Opinion on a hospital arrangement in which the hospital was using its employed nurse practitioners to...more

NY Pharmacy Owners Plead Guilty to Money Laundering During COVID-19

The U.S. Department of Justice (DOJ) announced on November 16 that two pharmacy owners from Forest Hills, New York have pleaded guilty to conspiracy to commit money laundering through submission of fraudulent claims to...more

Pharmacy Owners Charged for Fraud and Kickbacks to a Marketing Company

The U.S. Department of Justice recently announced that a federal grand jury has charged two pharmacy owners, a mother-daughter duo from South Florida, with healthcare fraud, wire fraud, and payment of kickbacks in exchange...more

OIG Concludes that $25 Patient Gift Card Presents Low Risk of Fraud and Abuse

The U.S. Department of Health and Human Services’ Office of Inspector General (OIG) recently issued an Advisory Opinion on offering gift cards to patients for completing an online patient education program....more

Employer Alert: First Deadline to Claim NYS Healthcare Worker Bonus is September 2

As part of its 2023 state budget, New York State has allocated $1.2 billion for the payment of bonuses to certain frontline healthcare workers. This bonus program is intended to reward healthcare workers for their services...more

University Health Center Pays $875,000 in HIPAA Fines after Cyber Hack

Oklahoma State University’s Center for Health Services recently paid $875,000 to settle potential HIPAA violations after a cyberattack resulted in the unauthorized access of its patients’ protected health information. A...more

OIG Issues Favorable Opinion for Providing Free Smartphones to Patients to Promote Telehealth Services

The increased use of telehealth services is a trend that is expected to continue long after the COVID-19 pandemic ends. In keeping with this trend, the U.S. Department of Health and Human Services’ Office of Inspector General...more

OIG Approves Hospital “Warranty” On Joint Replacement Procedures

The U.S. Department of Health and Human Services’ Office of Inspector General (OIG) recently issued a favorable Advisory Opinion on an arrangement that would allow a hospital to offer free items and services to patients who...more

OIG Issues Favorable Advisory Opinion On Arrangement between Medigap Plan And Hospital Network

On August 16, the U.S. Department of Health and Human Services’ Office of Inspector General (OIG) issued a favorable Advisory Opinion regarding an arrangement between a Medicare Supplemental Health Insurance (“Medigap”) plan...more

OIG Issues Favorable Advisory Opinion On Hospital/Physician Joint Venture ASC

In a recent advisory opinion, the U.S. Department of Health and Human Services’ Office of Inspector General (OIG) concluded that certain investments by a health system, manager and physicians in an ambulatory surgery center...more

Free Drug Program Avoids Sanctions Under AKS

In a recent advisory opinion, the U.S. Department of Health and Human Services’ Office of Inspector General (OIG) determined not to impose sanctions under the federal Anti-Kickback Statute (AKS) on a drug manufacturer program...more

HHS Relaxes Rules On Administering COVID-19 Vaccines

On January 28, the U.S. Department of Health and Human Services (HHS) announced that it has amended the Declaration under the Public Readiness and Emergency Preparedness Act (PREP Act) to expand the types of providers that...more

Relief Bill Revamps COVID-19 Telehealth Program

The most recent COVID-19 relief bill that was signed into law in December includes $250 million in new funding for the federal COVID-19 Telehealth Program, previously discussed here. The program was originally established in...more

Anthem Agrees to $48 Million Multi-State Settlements Over 2014 Data Breach

Health insurer Anthem, Inc. has finally reached a settlement with a coalition of 41 states plus the District of Columbia, and a separate settlement with California, to resolve state attorney general investigations of a data...more

OCR Announces Five HIPAA “Right of Access” Settlements

On September 15, the U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) announced five new settlements relating to enforcement of HIPAA’s right of access rule. Under HIPAA, patients have the right to...more

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