In a September 2022 brief concerning program integrity, the Health and Human Services Office of Inspector General (OIG) identified seven measures to identify providers who may present a high risk for improper Medicare...more
Earlier this month, the United States Department of Health and Human Services’ Office of Civil Rights (“OCR”), the organization that has jurisdiction over enforcement of the Health Insurance Portability and Accountability Act...more
12/20/2022
/ Cookies ,
Cybersecurity ,
Data Privacy ,
Department of Health and Human Services (HHS) ,
Electronic Protected Health Information (ePHI) ,
Health Care Providers ,
Health Insurance Portability and Accountability Act (HIPAA) ,
OCR ,
Patient Privacy Rights ,
PHI ,
Popular
In my experience, most physician groups rely on the “in-office ancillary service” exception to the Stark Law when determining how to allocate revenues from designated health services among group members. The Stark Law is, of...more
On November 4, 2021, the Centers for Medicare & Medicaid Services (“CMS”) issued Interim Final Rules requiring many of its regulated providers and suppliers to require staff and employees to meet COVID-19 vaccination...more
The Office of Civil Rights (“OCR”), which is the federal agency that enforces the health care privacy rules under the Health Insurance Portability and Accountability Act (“HIPAA”), recently published guidance covering various...more
Late last week, the United States Department of Health and Human Services (HHS), Office for Civil Rights issued a Notice of Proposed Rulemaking (NPR) to make significant revisions to the Health Insurance Portability and...more
The Evers administration just announced a new grant funding program for long-term care, home and community based services, and emergency medical services. The grant program is funded by the federal Coronavirus Aid, Relief,...more
As we previously predicted, the Centers for Medicare and Medicaid Services (“CMS”) has continued to issue expansions of the Blanket Waivers applicable during the COVID-19 pandemic. CMS states the reason for issuing these...more
The Office of Civil Rights’ “Notification of Enforcement Discretion” regarding COVID- 19 and remote telehealth communications do not apply to information protected under 42 CFR Part 2. These Part 2 regulations protect the...more
Use of the Wisconsin Caregiver Misconduct online reporting portal is mandatory beginning May 1, 2020 for some providers and on June 1, 2020 for others. Most providers will have until June 1, 2020 to be compliant with the...more
The Centers for Medicare & Medicaid Services (CMS) has issued another set of regulatory changes and waivers intended to deliver expanded care to the nation’s seniors, and provide flexibility to the healthcare system during...more
The Centers for Medicare & Medicaid Services (CMS) issued Blanket Waivers of certain requirements of the Physician Self-Referral Law (Stark Law). The purpose for the Blanket Waivers is to provide the flexibility providers...more
The Coronavirus Aid, Relief, and Economic Security Act (“CARES Act”) became law on March 27, 2020. One provision that has not received much coverage is the requirement for providers of COVID-19 diagnostic testing to publish...more
The Health and Human Services (HHS) Office of Inspector General (OIG) issued a Policy Statement on March 17, 2020 regarding the waiver of amounts owed by beneficiaries for services provided by telehealth. Recognizing the...more
The Centers for Medicare & Medicaid Services (CMS) have issued new recommendations targeted at communities in Phase 1 of the Guidelines for President Trump’s “Opening Up America Again.” The Phase 1 category includes...more
The Blanket Waivers that the Center of Medicare and Medicaid services issued under the Stark Law apply only to financial relationships and referrals that are related to the national emergency that is the COVID-19 outbreak in...more
The following is a list of categories of the Stark Law Blanket Waivers permitting deviations from the provisions of the Stark Law where necessary for a COVID-19 purpose. See Background on CMS Stark Law Waiver. The definition...more
The Centers for Medicare & Medicaid Services published at the end of March new blanket waivers under the federal physician self-referral law (commonly known as the Stark Law) in response to the COVID-19 pandemic. The waivers...more
Our representation of behavioral health and substance abuse programs has required us to stay in tune to issues involving special confidentiality of patient records under 42 CFR Part 2, also known as the SAMHSA regulations The...more
Congress has activated a new Anti-Kickback law known as Eliminating Kickbacks in Recovery Act of 2018 (commonly referred to as EKRA). The new Anti-Kickback law applies to arrangements involving recovery homes, clinical...more
6/14/2019
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Clinical Laboratories ,
Criminal Prosecution ,
Eliminating Kickbacks in Recovery Act of 2018 (EKRA) ,
Health Care Providers ,
Healthcare Facilities ,
Healthcare Reform ,
Opioid ,
Pharmaceutical Industry ,
Physicians ,
Prescription Drugs ,
Safe Harbors ,
Substance Abuse
The Affordable Care Act requires any person who has received an overpayment from certain defined government health programs to report and return the overpayment within 60 days after the overpayment is identified. If an...more
The Department of Justice (DOJ) along with other health care fraud enforcement agencies, continue to send strong signals that they want businesses to police themselves for potential compliance issues and self-disclose where...more
5/29/2019
/ Compliance ,
Cooperation ,
Corporate Misconduct ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Government Investigations ,
Health Care Providers ,
Inspector General ,
New Guidance ,
Remediation ,
Self-Disclosure Requirements
HIPAA, as a body of regulations protecting the confidentiality of patient health care information, has been branded very effectively. Most staff at your average health care facility know about HIPAA and that it protects the...more
Well, it’s a start. New Medicare rules kicked in starting January 1, 2019 that are aimed at focusing less provider time on paperwork and more on patient care in inpatient rehabilitation facilities. Any change that reduces...more
A recent Advisory Opinion (Advisory Opinion 18-03) from the Office of Inspector General (OIG) of the Department of Health and Human Services addresses potential kickback issues involved in the donation of telehealth...more