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Updated INSPECT Requirements Will Streamline Practitioner Obligations

By: Stacy Walton Long and Andrew W. Breck on May 1, 2019

A new bill recently cleared  Indiana’s legislature that will change the requirements of Indiana’s Scheduled Prescription Electronic Collection and Tracking (“INSPECT”) program.  The bill modifies the changes enacted last year that made failure to check the INSPECT database prior to prescribing an…

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Students, Consultants and Other Business Visitors...Important Safeguards

By: Susan E. Ziel and Robert A. Anderson on May 1, 2019

If you are a health care clinic or other office setting, do you have a policy that governs those individuals or “business invitees” who may request and be granted the opportunity to observe or participate in some aspect of your business or clinical operations for a legitimate business purpose?…

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Recent HOPD Address Issues

By: Thomas N. Hutchinson and Meghan M. Linvill McNab on May 1, 2019

Beginning in April 2019, CMS started returning OPPS claims where the Hospital Outpatient Department address on the claim does not match the exact address appearing on the hospital’s Medicare Form 855A.

These include claims returned for using “Ste.” instead of “Suite” or “St.” instead of “Street.”

Be…

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Is Your Organization in Compliance With IRS Rules on Employer Identification Numbers?

By: Kendall A. Schnurpel on April 29, 2019

On March 27, 2019 the IRS announced that taxpayers can no longer request an employer identification number (“EIN”) unless the “responsible party” named on the application has a Social Security number (“SSN”) or Individual Taxpayer Identification Number (“ITIN”). This change goes into effect on May…

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Medical Record Documentation: Is it a “No” or a “Not Completed”?

By: Robert A. Anderson and Meghan M. Linvill McNab on April 9, 2019

The United States Department of Justice (“DOJ”) issued a press release regarding a recent $2 Million settlement related to allegations that a provider violated the False Claims Act by submitting inflated and upcoded evaluation and management (“E/M”) claims to Medicare and Medicaid, over a five year…

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New Medicare Payment Model for Emergency Ambulance Services

By: Meghan M. Linvill McNab and Amanda K. Schipp on April 9, 2019

On February 14, 2019, the Center for Medicare and Medicaid Innovation (“CMMI”) announced a new payment model for Medicare emergency ambulance services called the “Emergency Triage, Treat and Transport (“ET3”) Model.  The goal of the ET3 Model is to allow Medicare Fee-For-Service beneficiaries to…

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OCR Concludes Investigation of Allegations that the State of Hawaii Unlawfully Discriminated Against Pregnancy Resource Centers

By: Robert A. Anderson and on April 8, 2019

On March 21, 2019, the Office for Civil Rights (“OCR”) at the U.S. Department of Health and Human Services (“HHS”) issued a resolution to resolve complaints brought against the State of Hawaii by two pregnancy resource centers (the “Centers”). The Centers brought the complaints in 2017 alleging…

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D.C. District Court Invalidates Medicaid Work Requirements

By: and Brandon W. Shirley on April 8, 2019

D.C. District Court Judge James Boasberg invalidated Federally approved Medicaid work requirements in Kentucky and Arkansas and sent the question back to the Centers for Medicare and Medicaid Services (“CMS”) for further analysis. The March 27, 2019 decision is a legal setback for CMS and states…

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HIPAA, Individual Rights and Personal Representatives

By: Susan E. Ziel and on April 8, 2019

The Health Insurance Portability and Accountability Act of 1996, as amended by the Health Information Technology for Economic and Clinical Health or “HITECH” Act  (hereinafter “HIPAA”)1 establishes numerous obligations for HIPAA covered entities and business associates.  

One obligation, in…

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Going, Going, Gone - Important Medical Records Considerations for Physicians Planning to Close Their Practice

By: Susan E. Ziel and Stacy Walton Long on March 25, 2019

The Indiana Administrative Code, specifically 844 IAC, Article 5, establishes certain professional standards for physicians licensed in the State of Indiana. One particular section, 844 IAC 5-2-16, sets forth requirements governing the discontinuation of a physician’s practice due to retirement or…

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HIPAA Violation Leads to Criminal Conviction of Former Patient Coordinator

By: Robert A. Anderson and on March 19, 2019

A former Patient Information Coordinator (Patient Coordinator), previously employed with UPMC and its affiliate, Tri Rivers Musculoskeletal Centers (TRMC) in Mars, Pennsylvania, pleaded guilty to a charge of wrongfully disclosing health information, in violation of the Health Insurance Portability…

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Illinois Appeals Court Upholds Denial of Property Tax Exemption for Hospice Center

By: Kendall A. Schnurpel and Robert A. Anderson on March 10, 2019

In an opinion issued on February 25, 2019, the Illinois Appellate Court confirmed that a not-for-profit hospice provider was not entitled to a charitable use property tax exemption because it was not exclusively engaged in charity care. See Midwest Palliative Hospice and Care Center v. Constance…

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