A quick peek at CMS’ FY 2018 budget (and beyond) indicates that CMS is investing heavily in rules enforcement.[1] Encouraged by a Fraud Prevention System return on investment of $11.50 for every $1.00 spent[2], CMS sees enhanced enforcement as a critical means of keeping (and returning) financial…
As part of the August, 14, 2017 Inpatient Prospective Payment System (“IPPS”) Final Rule[1], the Centers for Medicare and Medicaid (“CMS”) revised the public notice requirements for Medicare provider agreement terminations.
Previously, a Rural Health Clinic (“RHC”), Federally Qualified Health…
After months of negotiations, Senate Majority Leader Mitch McConnell failed to find enough Republican support to advance some form of health care reform legislation late last week. Accordingly, the Patient Protection and Affordable Care Act (“ACA”) continues to remain the law of the land, though…
Without surprise, not many hospital providers joined in the celebration of EMTALA’s recent 30th anniversary. A lack of shared joy notwithstanding, EMTALA remains as rigorous, nuanced, and enforced as when it was first enacted as part of the 1986 COBRA legislation.
The broad requirements of EMTALA…
A June 12, 2017, OIG report indicates that, between 2001 and 2014, CMS paid $730 million in electronic healthcare record (“EHR”) incentive payments to eligible professionals (“EPs”) who did not comply with Federal requirements for “meaningful use” of EHRs. In other words, the OIG believes these…
On June 30, 2017, CMS published a proposed rule with changes and policy updates to the Quality Payment Program (“QPP”) for calendar year 2018. The QPP, established under the Medicare Access and CHIP Reauthorization Act of 2015 (“MACRA”), includes two pathways for participation, the Merit Based…
Indiana’s seven day script law for new patients, Senate Enrolled Act (“SEA”) 226, went into effect on July 1, 2017.[1] Under SEA 226, the general rule is as follows: A prescriber may not issue more than a seven day supply of an opioid if the prescriber is prescribing to an adult patient for the…
A Texas District Court judge presiding over a lawsuit challenging a Federal Regulation that expands protections to transgender patients, among others (“Rule”) recently agreed to stay judicial proceedings while the Health and Human Services (“HHS”) agency reviews the Rule. The court had earlier…
The 120th Indiana General Assembly recently enacted legislation to revise Indiana Code (“IC”) 4-6-14 regarding abandoned health records. Under the current statute, the attorney general (“AG”) may take possession of, store, maintain, transfer, protect, or destroy health records that the AG…
FileFax, Inc. (“FileFax”) is a Business Associate of the Center for Children’s Digestive Health (“Center”). The Center is a small, for-profit healthcare provider with a subspecialty practice in pediatrics. Since 2003, FileFax stored inactive paper medical records that contained protected health…
On or about December 5, 2011, a hacker accessed email accounts of employees of Metro Community Provider Network (“Metro”), a federally-qualified health center, and acquired 3,200 individuals’ electronic protected health information (“ePHI”) via a phishing incident[1]. Accordingly, on January 27,…
A frequent question from physicians is: What do I do if I have a patient who does not pay his or her bill? And for those physicians who are thinking ahead: What can I do to avoid having a patient who does not pay his or her bill? This article briefly addresses strategies physicians may try to…
