The recently unveiled California Health and Human Services Data Exchange Framework (the Framework) creates a new regulatory and governance structure to promote the exchange of health information between health care providers...more
9/9/2022
/ California ,
Data Privacy ,
Data-Sharing ,
Department of Health and Human Services (HHS) ,
Electronic Medical Records ,
Electronic Protected Health Information (ePHI) ,
Governance Standards ,
Health Care Providers ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Hospitals ,
Medi-Cal ,
PHI ,
Physicians ,
Policies and Procedures
Click the link below for our complete analysis of recent updates to the Stark Law and Anti-Kickback Statute and their impact on health care providers.
...more
3/3/2021
/ 21st Century Cures Act ,
Anti-Kickback Statute ,
Bonuses ,
Centers for Medicare & Medicaid Services (CMS) ,
Civil Monetary Penalty ,
Commercially Reasonable Efforts ,
Cybersecurity ,
Department of Health and Human Services (HHS) ,
Fair Market Value ,
Final Rules ,
Health Care Providers ,
Health Insurance ,
Medicare Part D ,
OIG ,
Pharmacy Benefit Manager (PBM) ,
Profit Sharing ,
Safe Harbors ,
Stark Law ,
Value-Based Care
Fraud and abuse regulations have been adapted to meet today’s technology for electronic data, promoting cooperation among health care providers for the exchange of health information and the protection of such information...more
2/1/2021
/ Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Cybersecurity ,
Data Protection ,
EHR ,
Electronic Protected Health Information (ePHI) ,
Final Rules ,
Fraud and Abuse ,
Health Care Providers ,
OIG ,
ONC ,
Stark Law
Recognizing the need to make health services available during the current state of emergency, California Governor Gavin Newsom issued Executive Order N-43-20 (the “Order”) on April 3, 2020.
The Order temporarily expands the...more
4/14/2020
/ Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
Department of Homeland Security (DHS) ,
Emergency Response ,
Executive Orders ,
Governor Newsom ,
Health Care Providers ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Medicare ,
OCR ,
Physician Medicare Reimbursements ,
Physicians ,
Public Health ,
Relief Measures ,
Telehealth ,
Telemedicine ,
Waivers
A software developer of an electronic health records system utilizing AI is the recent target in a DOJ fraud investigation.
On January 27, 2020, the DOJ announced that Practice Fusion, Inc. entered into a deferred...more
2/5/2020
/ Artificial Intelligence ,
Criminal Investigations ,
Criminal Liability ,
Deferred Prosecution Agreements ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Drug Treatment ,
Electronic Medical Records ,
Failure to Comply ,
Government Investigations ,
Health Care Providers ,
Health Information Technologies ,
Healthcare Fraud ,
Kickbacks ,
Opioid ,
Pharmaceutical Industry ,
Physicians ,
Popular ,
Prescription Drugs ,
Regulatory Requirements ,
Software Developers
On September 10, 2019, the Centers for Medicare and Medicaid Services (CMS) issued a final rule with comment period, titled Program Integrity Enhancements to the Provider Enrollment Process (the “Final Rule”), which enhances...more
9/30/2019
/ Affiliates ,
Bad Actors ,
Centers for Medicare & Medicaid Services (CMS) ,
Children's Health Insurance Program (CHIP) ,
Comment Period ,
Disclosure Requirements ,
Enforcement Authority ,
Enrollment ,
Final Rules ,
Health Care Providers ,
Medicaid ,
Medicare ,
Reporting Requirements