A proposed rule released by the U.S. Department of Health and Human Services on December 10 would give healthcare providers more flexibility to share patients’ health information for certain purposes. The rule, titled...more
The 2021 Physician Fee Schedule (PFS) final rule recently released by the Centers for Medicare & Medicaid Services (CMS) includes the addition of 60 new telehealth services that will be covered and reimbursed by Medicare. The...more
12/11/2020
/ Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Final Rules ,
Health Care Providers ,
Health Technology ,
Medicare ,
Physician Fee Schedule ,
Physicians ,
Reimbursements ,
Telehealth ,
Telemedicine
The U.S. Department of Justice announced on November 20 that Doctor’s Choice Home Care, Inc. agreed to pay $3,856,000 to resolve allegations that the agency paid illegal kickbacks to physicians for referring patients. The...more
On November 20, the Centers for Medicare & Medicaid Services (CMS) and the Department of Health and Human Services’ Office of Inspector General (OIG) announced the issuance of long-awaited final rules to modernize the Stark...more
The U.S. Department of Health and Human Services’ Office of Inspector General (OIG) issued a Special Fraud Alert on November 16, warning that speaker programs organized by pharmaceutical and medical device companies pose...more
The U.S. Department of Justice (DOJ) announced on October 29 that Medtronic USA Inc. agreed to pay $8.1 million to settle allegations that it violated the False Claims Act (FCA) and federal Anti-Kickback Statute by paying...more
11/13/2020
/ Affordable Care Act ,
Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Civil Monetary Penalty ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Health Care Providers ,
Healthcare Fraud ,
Medical Devices ,
Medicare
The city of New Haven, Connecticut recently agreed to pay $202,400 to the U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) to settle multiple HIPAA violations in connection with a 2016 incident at...more
The U.S. Department of Health and Human Services’ Office for Civil Rights’ HIPAA Right of Access Initiative has claimed another victim. HHS announced on October 9 that NY Spine Medicine, a private neurology and pain...more
On September 23, the U.S. Department of Justice announced that pharmaceutical company Gilead Sciences, Inc. agreed to pay $97 million to resolve claims that it illegally used a foundation as a conduit to pay the copays of...more
The third HIPAA settlement to be announced by the U.S. Department of Health and Human Services within one week was a big one. On September 25, HHS announced that Premera Blue Cross agreed to pay $6.85 million to HHS’s Office...more
The U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) recently unveiled a new website with updated guidance and resources for mobile health app developers regarding the HIPAA Privacy, Security, and...more
9/25/2020
/ App Developers ,
Application Programming Interface (APIs) ,
Cybersecurity ,
Department of Health and Human Services (HHS) ,
Electronic Medical Records ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Medical Devices ,
Mobile Apps ,
OCR ,
Telehealth ,
Wearable Technology
On September 21, the U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) announced a $1.5 million agreement with Athens Orthopedic Clinic PA to settle “longstanding, systemic noncompliance” with the...more
Amazon recently introduced the Halo fitness tracker, its first entry into the health wearables market currently dominated by Fitbit and the Apple Watch. Amazon’s previous efforts to move into the healthcare industry have...more
Teva Pharmaceuticals USA Inc. is in the crosshairs of the U.S. Department of Justice (DOJ) on two separate matters. On August 18, the DOJ announced that it filed a lawsuit against Teva and an affiliate, Teva Neuroscience...more
8/27/2020
/ Co-payments ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
FBI ,
Healthcare Fraud ,
Kickbacks ,
Medicare ,
Pharmaceutical Industry ,
Prescription Drugs ,
Price-Fixing ,
Private Foundations ,
Settlement
After a long quiet period, the second HIPAA settlement to be announced by the U.S. Department of Health and Human Services (HHS) in an orchestrated one-two punch was far more costly to the second violator. Lifespan Health...more
The U.S. Department of Health and Human Services (HHS) announced on July 23 that Metropolitan Community Health Services (Metro) paid $25,000 to HHS’s Office for Civil Rights (OCR) to resolve HIPAA violations. Metro, a...more
The U.S. Department of Health and Human Services (HHS) and Department of Justice (DOJ) have released the 2019 annual report for their Health Care Fraud and Abuse Control Program. The government recovered almost $3.6 billion,...more
7/23/2020
/ Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Electronic Medical Records ,
False Claims Act (FCA) ,
FBI ,
Fraud ,
Genetic Testing ,
Healthcare Fraud ,
Home Health Care ,
Medicaid ,
Medical Devices ,
Medicare ,
Prescription Drugs ,
Telehealth
The Federal Communications Commission (FCC) is adding $198 million in funding to the Rural Health Care Program to help healthcare providers acquire telecommunications and broadband services. The funding is in addition to $200...more
On July 13, the Substance Abuse and Mental Health Services Administration (SAMHSA) announced the adoption of revised Confidentiality of Substance Use Disorder Patient Records regulations in an effort to improve care...more
The Visiting Nurse Service of New York (VNSNY) has agreed to pay $57 million to settle a whistleblower lawsuit that alleged it billed the Medicare and Medicaid programs for hundreds of millions of dollars in home care visits...more
6/29/2020
/ False Billing ,
False Claims Act (FCA) ,
Home Health Agencies ,
Hospice ,
Medicaid ,
Medicare ,
New York ,
Nonprofits ,
Nurses ,
Patient Referrals ,
State and Local Government ,
Whistleblower Awards ,
Whistleblowers
On June 16, the U.S. Court of Appeals for the District of Columbia Circuit upheld a ruling from a year ago that struck down a federal regulation requiring pharmaceutical companies to disclose wholesale prices of prescription...more
On May 28, the Federal Communications Commission (FCC) announced that its COVID-19 Telehealth Program has now approved a total of over $68 million in funding for 185 hospitals and other healthcare providers in 38 states plus...more
On April 30, the Centers for Medicare & Medicaid Services (CMS) announced numerous regulatory waivers and rule changes to, among other things, expand Medicare beneficiaries’ access to coronavirus testing and telehealth...more
On April 6, Rivkin Radler’s Robert Iseman presented a COVID-19 Business Briefing on the Paycheck Protection Program that was created under the Coronavirus Aid, Relief and Economic Security Act (CARES Act). Administered by the...more
On April 6, Rivkin Radler’s Eric Fader presented a COVID-19 Business Briefing on Telehealth. The Briefing covered recent developments in federal and state law and policy, and changes in private insurers’ policies, that have...more