See below for the CMS (Centers for Medicare & Medicaid Services) Announcement on July 10, 2024 proposing a reduction in the Medicare Conversion Factor payment from $33.29 to $32.36, i.e. 2.8%...more
CMS proposed several telehealth changes in the 2025 Medicare Physician Fee Schedule Proposed Rule, issued July 10, 2024....more
The Allegheny County Medical Society has reported that the Pennsylvania House of Representatives has passed a bill to bar non-compete agreements in healthcare employment....more
The healthcare sector is particularly vulnerable to cybersecurity risks and the stakes for patient care and safety are particularly high. Healthcare facilities are attractive targets for cyber criminals in light of their...more
1/16/2024
/ Biden Administration ,
Cyber Attacks ,
Cyber Incident Reporting ,
Cybersecurity ,
Data Breach ,
Department of Health and Human Services (HHS) ,
Health Care Providers ,
Healthcare Facilities ,
OCR ,
Popular ,
Ransomware
CMS has halted the arbitration process for “Surprise Billing” established by the “No Surprises Act” for the second time, stating as follows...more
The 2024 Medicare Physician Fee Schedule proposes a 3.34% decrease in the 2024 PFS conversion factor. It’s currently $33.89 and is proposed to be reduced to $32.75....more
Since the private equity issue was last addressed in the Bulletin in the Summer of 2022, the volume of healthcare private equity deals has subsided somewhat, according to statistics presented at the March 2023 Pennsylvania...more
5/1/2023
/ Acquisitions ,
Centers for Medicare & Medicaid Services (CMS) ,
Congressional Investigations & Hearings ,
Corporate Practice of Medicine ,
Health Care Providers ,
Hospitals ,
Investment ,
Investors ,
Motor Vehicle Safety Whistleblower Program (MVSWP) ,
Private Equity ,
Private Equity Firms
On January 5, 2023, the Federal Trade Commission (FTC) took a dramatic step by proposing a new rule that would prohibit companies from entering into non-compete agreements with its workers. The proposed rule, if approved,...more
2/3/2023
/ Employment Contract ,
Federal Trade Commission (FTC) ,
Health Care Providers ,
Independent Contractors ,
Non-Compete Agreements ,
Nonprofits ,
Physicians ,
Proposed Rules ,
Public Comment ,
Restrictive Covenants ,
Unfair Competition
The final “2023 Omnibus Bill” which is the spending bill passed by Congress and signed by President Biden at the end of 2022, provides partial relief from the scheduled Medicare Physician Fee Schedule Conversion Factor cuts. ...more
The US Office of Inspector General (OIG) released another in a series of Special Fraud Alerts on July 20, 2022, this one directed to potentially fraudulent telehealth, telemedicine, and telemarketing service fraud schemes,...more
The Cyber Incident Reporting for Critical Infrastructure Act (CIRCIA), was passed as part of the consolidated Budget Act for 2022, which also included the telehealth provisions.
The definition of “covered entity” in the...more
HHS sent notices to noncompliant physicians and facilities on March 10, 2022 giving them 30 days to return funds paid to healthcare providers who have not complied with the agency’s reporting requirements....more
The President and Congress extended Medicare telehealth coverage in the Consolidated Appropriations Act, which also included additional Ukrainian relief.
On Tuesday, March 15, 2022, President Biden signed the Consolidated...more
There has been much discussion and controversy over the new CMS position on billing for split/shared services in facility settings.
As originally proposed, and starting in January 2022, if the service was shared among...more
There is almost universal agreement regarding predictions for 2022 federal enforcement in the following areas:
..The use of fraudulently obtained COVID relief funds in both healthcare and in general, but specifically as...more
1/20/2022
/ Audits ,
Centers for Medicare & Medicaid Services (CMS) ,
Compliance ,
Coronavirus/COVID-19 ,
Corporate Misconduct ,
Department of Justice (DOJ) ,
Enforcement ,
False Claims Act (FCA) ,
Fraud and Abuse ,
Health Care Providers ,
Personal Liability ,
Physicians ,
Relief Measures ,
Yates Memorandum
The Pennsylvania Senate announced on October 26, 2021 that it has passed Senate Bill 705, and a copy of the Senate Press Release can be found here.
A previous telemedicine bill was passed in Pennsylvania in July of 2018,...more
In the August 12, 2021 MLN Connects News, CMS announced resumption of TPE Program.
...more
In previous Med Law Blog posts, we have featured examples of increased enforcement in the telehealth area, including the recent creation of the National Rapid Response Strike Force, announced by the Department of Justice on...more
Medical practices are now beginning to encounter Medicare payment claw backs by CMS for COVID Accelerated and Advanced Payments (CAAP) and Department of Justice (DOJ) prosecution for Paycheck Protection Program (PPP)...more
4/22/2021
/ Advanced Payment Program ,
Centers for Medicare & Medicaid Services (CMS) ,
Clawbacks ,
Coronavirus/COVID-19 ,
Criminal Liability ,
Criminal Prosecution ,
Department of Justice (DOJ) ,
Fraud and Abuse ,
Health Care Providers ,
Medicare ,
Paycheck Protection Program (PPP)
On December 10, 2020, the Department of Health and Human Services (HHS) and the Office of Civil Rights (OCR) collaborated on announcing proposed HIPAA changes, intended to “empower patients” and “improve coordination of...more
EHR Safe Harbor Permanent -
The existing electronic health records items and services Safe Harbor in 42 CFR Section 1001.952(y) was amended by deleting the sunset provision, thereby making the protection permanent....more
Most medical practices view HIPAA compliance as maintaining appropriate documentation regarding patient notices and consents, and controlling access to the PHI within the office; that’s PRIVACY. Practices tend to forget the...more
The American Health Law Association and Health IT News recently published reports indicating enormous increases in telehealth hacking attacks.
Sam Kassoumeh, COO of Health IT News and Co-Founder of SecurityScorecard,...more
Attached is a link to the fact sheet for “proposed policy, payment, and quality provisions changes to Medicare physician fee schedule for calendar year 2021”.
Among other things, Centers for Medicare & Medicaid Services...more
Centers for Medicare & Medicaid Services (CMS) published the new hospital outpatient and ambulatory surgical center fee schedule for 2021 on August 12, 2020.
As part of the proposed revisions, CMS intends to transfer over...more