Rivkin Rounds’ first annual Fraud Week kicks off with kickbacks. The U.S. Department of Justice (DOJ) recently announced that the owner of Boerne Drug in Boerne, Texas was indicted on conspiracy charges for his role in an...more
The U.S. Department of Justice (DOJ) recently announced that Reliance Medical Systems LLC, a Utah-based distributor of spinal implant devices, two of its individual owners, and two of its physician-owned distributorships...more
On July 20, the U.S. Department of Health and Human Services’ Office of Inspector General (OIG) issued a Special Fraud Alert to caution healthcare practitioners who may wish to enter into arrangements with telehealth...more
7/27/2022
/ Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
False Billing ,
Health Care Providers ,
Healthcare Fraud ,
Kickbacks ,
OIG ,
Physicians ,
Telehealth ,
Unnecessary Medical Procedures
On July 15, U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra formally extended the COVID-19 public health emergency for another 90 days. ...more
On May 27, the U.S. District Court for the Northern District of California refused to dismiss a lawsuit brought against Envision Healthcare Corp. alleging violations of California’s corporate practice of medicine (CPOM)...more
A New York woman was sentenced last month to 78 months in prison for defrauding healthcare programs, including obtaining more than $6.5 million from Medicare Part D plans and Medicaid drug plans....more
On April 20, the U.S. Department of Justice (DOJ) announced criminal charges against 21 people across the country for COVID-19-related frauds. The defendants are accused of over $149 million in false billings to federal...more
4/28/2022
/ CARES Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Counterfeiting ,
Department of Justice (DOJ) ,
False Billing ,
Federal Funding ,
Fraud ,
Kickbacks ,
Medicare ,
National Center for Disaster Fraud (NCDF) ,
Vaccinations
On April 12, Department of Health and Human Services (HHS) Secretary Xavier Becerra extended the COVID-19 public health emergency for another 90 days. The PHE had been scheduled to expire on April 16....more
New York’s 2023 state budget, signed into law on April 9, included an amendment to the state’s Education Law establishing 3,600 practice hours as a threshold beyond which nurse practitioners no longer require a collaborative...more
On March 28, the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) announced four new enforcement actions against healthcare providers for HIPAA violations....more
This is outside our usual catchment area, but interesting nonetheless. The Indiana Supreme Court ruled on March 8 that the state’s Medical Malpractice Act (MMA) does not apply to claims for indemnification filed by one...more
At the beginning of the COVID-19 pandemic, the Centers for Medicare & Medicaid Services expanded Medicare coverage for telehealth nationwide, as discussed here. The $1.5 trillion omnibus spending bill signed into law by...more
The U.S. Department of Justice (DOJ) announced on March 3 that Ameet Goyal, M.D., a Westchester-based ophthalmologist, was sentenced to 96 months in prison for falsely billing for millions of dollars of upcoded procedures...more
In a February 23 order, the U.S. District Court for the Eastern District of Texas vacated a controversial rule issued in September that implemented the independent dispute resolution (IDR) procedure under the federal No...more
The U.S. Department of Health and Human Services’ Health Sector Cybersecurity Coordination Center (HC3) recently issued a report entitled “Electronic Medical Records in Healthcare” that discussed security risks applicable to...more
We don’t often cover brand-new proposed legislation on Rivkin Rounds, generally preferring to wait until it’s closer to becoming law. However, two bipartisan bills introduced in Congress last week are worthy of mention....more
2/15/2022
/ Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Electronic Protected Health Information (ePHI) ,
Health Care Providers ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Legislative Agendas ,
Medicare ,
PHI ,
Privacy Laws ,
Proposed Legislation ,
Telehealth
New York Gov. Kathy Hochul announced on February 2 that the state will make available more than $100 million in funding over the next five years for 12 new Intensive Crisis Stabilization Centers across the state. The...more
On January 24, New York Attorney General Letitia James announced a settlement with EyeMed Vision Care LLC based on shortcomings in the company’s data security procedures. The problems were discovered during the state’s...more
2/1/2022
/ Breach Notification Rule ,
Cybersecurity ,
Data Breach ,
Hackers ,
Health Information Technologies ,
Medicaid ,
Medicare ,
PHI ,
Policies and Procedures ,
Popular ,
State Attorneys General
The federal No Surprises Act, effective January 1, 2022, established new requirements for healthcare providers, facilities, and providers of air ambulance services to protect consumers from “surprise” medical bills. These...more
On December 22, the Connecticut Department of Public Health (DPH) announced that it issued an Order temporarily suspending the requirements for state licensure, certification or registration of physicians, nurses, and certain...more
A study recently released by the U.S. Department of Health and Human Services (HHS) found that the number of beneficiaries in the traditional Medicare program who used telehealth increased from 840,000 in 2019 to nearly 52.7...more
The 2022 Medicare Physician Fee Schedule Final Rule released on November 2 by the Centers for Medicare & Medicaid Services (CMS) added certain services to the Medicare telehealth services list through December 31, 2023. Last...more
Please join us as Rivkin Radler Partner Eric D. Fader provides an overview of changes in the provision of telehealth services and federal and state regulation of them, since the beginning of the COVID-19 pandemic. New rules...more
10/27/2021
/ Continuing Legal Education ,
Coronavirus/COVID-19 ,
Data Privacy ,
Data Security ,
Health Care Providers ,
Healthcare Fraud ,
Medical Billing Codes ,
Medicare ,
New Rules ,
Out of Network Provider ,
Physicians ,
Telehealth ,
Telemedicine ,
Webinars
The New Jersey Attorney General’s Office announced on October 12 that Diamond Institute for Infertility and Menopause, LLC, based in Millburn, NJ, will pay a $495,000 penalty for allegedly violating HIPAA and state law by...more
10/20/2021
/ Cyber Attacks ,
Cybersecurity ,
Data Breach ,
Data Protection ,
Data Security ,
Electronic Medical Records ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare Facilities ,
Medical Records ,
Popular ,
Privacy Policy ,
State Attorneys General ,
Third-Party Service Provider ,
Unauthorized Access
On September 30, the U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) announced that it issued guidance to clarify that the HIPAA Privacy Rule does not prohibit businesses from asking customers,...more