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
UPMC’s employment records were hacked by criminals in 2014. A civil class action lawsuit was filed on behalf of approximately 66,000 employees, and criminal cases were filed by federal prosecutors against a number of...more
7/29/2021
/ Class Action ,
Cyber Attacks ,
Cybersecurity ,
Data Breach ,
Data Security ,
Guilty Pleas ,
Hackers ,
PA Supreme Court ,
Personal Information ,
Popular ,
Tax Fraud
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
The Pennsylvania Department of Health has announced “Amendments to Charge for Medical Records”.
...more
CY 2021 Physician Fee Schedule Update -
On December 27, 2020, the Consolidated Appropriations Act modified the Calendar Year (CY) 2021 Medicare Physician Fee Schedule (MPFS)...more
Recent reports indicate that House and Senate Committee leaders have apparently mutually agreed on a bipartisan arrangement for correcting or preventing surprise medical bills, although legislation has not yet been...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
On December 2, 2020, the Department of Health and Human Services (HHS), the Office of Inspector General (OIG) and the Center for Medicare and Medicaid Services (CMS) will jointly publish the final regulations first proposed...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
The Resuming Business Toolkit is designed to assist employers in slowing the spread of COVID-19 and lowering the impact in their workplace when reintegrating employees into non-healthcare business settings. Not sure whether...more
On June 23, 2020, the United States District Court for the District of Columbia denied the American Hospital Association’s (AHA) summary judgment motion claiming the Trump Administration had exceeded its authority and...more
This is a link to the update of the OIG Work Plan that you will see it includes several new entries regarding COVID issues at nursing homes:
..Meeting the challenges presented by COVID
..Audit of nursing homes reporting...more
The COVID pandemic has illuminated the need to modernize professional licensing. Although professional licensing has always been a necessary vigilance with licensing has always been appropriate, and never more so than as...more
Although the Office of the Inspector General (“OIG”) has previously announced that it would exercise discretion with respect to financial arrangements entered into to facilitate and enhance the availability of COVID-19...more
The following are just some random thoughts or curated information regarding the impact the COVID pandemic will have on privacy in general, and health information privacy in particular.
I have attached a link to...more
Attached is a PDF issued by CMS regarding blanket waivers of the Stark Law in order to allow physicians and hospitals to adjust 18 different potential financial relationships in order to deal with the COVID-19 emergency. The...more
The open payment deadline for reporting is March 31, 2020, but CMS has released an updated FAQ, attached in the link below, indicating that, although the deadline is established by statute and cannot be changed by CMS, CMS...more