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Responding to Online Patient Reviews: Legal and Practical Considerations for Physicians

By: Thomas N. Hutchinson and on January 7, 2019

In the age of immediate access to online platforms such as Google, Yelp, and Healthgrades, patients are able to share physician reviews, many of which are positive, but at times can be negative and potentially false. Negative reviews are damaging to a physician’s professional and personal…

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Failure to Terminate Access to PHI Leads to HIPAA Violation

By: Stacy Walton Long and on December 17, 2018

The Health and Human Services’ Office of Civil Rights (“OCR”) recently entered into a Resolution Agreement with Pagosa Springs Medical Center (“PSMC”), resolving HIPAA violations over five years after the initial investigation began.1 On June 7, 2013, OCR initiated an investigation that revealed…

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Expanded Medicaid Treatment Options for Individuals with Substance Use Disorder and Serious Mental Illness

By: Stacy Walton Long and Amanda K. Schipp on December 17, 2018

This fall there have been a variety of federal initiatives aimed at expanding treatment options to address substance use disorder and mental illness. In late October, President Trump signed into law a comprehensive bipartisan opioid and substance abuse bill (available here) aimed at prevention,…

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Medicaid Presumptive Eligibility Moves to Fee-For-Service

By: Brandon W. Shirley and Amanda K. Schipp on December 17, 2018

Indiana Medicaid announced that, effective January 1, 2019, adults determined to be presumptively eligible for Medicaid will receive fee-for-service benefits during the presumptive eligibility (PE) coverage period. This change means that the enhanced benefits and additional flexibilities previously…

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Protecting Patient Information: The Importance of a Business Associate Agreement Under HIPAA

By: Stephanie T. Eckerle and on December 13, 2018

The Health and Human Services’ Office of Civil Rights (“OCR”) recently entered into a Resolution Agreement with a Florida physicians’ group, Advanced Care Hospitalists PL (“ACH”), after investigating an alleged HIPAA breach.1  Between November 2011 and June 2012, ACH obtained billing data processing…

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CMS Rule Reducing Medicare Payments for Certain Clinic Visits by Off-Campus PBDs

By: Meghan M. Linvill McNab and Brandon W. Shirley on December 12, 2018

The Bipartisan Budget Act (“BBA”) of 2015, and its implementing regulations at 42 CFR 419.22(v) and 419.48 resulted in the movement of payments for nonexcepted provider-based departments (“PBD”) from the outpatient prospective payment system (“OPPS”) to the Medicare Part B site-specific Physician…

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US Department of Justice Announces Changes to Corporate Investigation Protocol

By: Marc T. Quigley and Brandon W. Shirley on December 12, 2018

U.S. Deputy Attorney General Rod Rosenstein recently announced changes to criminal and civil corporate investigation protocol during a speech on November 29, 2018. For the past several years, the US Department of Justice (“DOJ”) has attempted to adhere to the Yates Memo, which focused on individual…

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NPDB Guidebook Changes

By: Brian M. Heaton and Meghan M. Linvill McNab on December 3, 2018

The US Department of Health & Human Services updated the National Practitioner Data Bank (“NPDB”) Guidebook, effective October 2018.  The last time the Guidebook was revised was April 2015.  While the 2015 revision included substantial updates to the regulatory scope, content and display of the…

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We May Finally Know Whether Being a Tricare Provider Makes One a Federal Contractor

By: Amy J. Adolay and Brandon W. Shirley on December 3, 2018

The U.S. Department of Labor (DOL) recently announced plans to clarify application of federal anti-discrimination requirements on health care providers with Tricare enrollment agreements. The DOL and Tricare providers have long been at odds over whether a Tricare enrollment agreement made one a…

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Important Organizational Safeguards to Manage Healthcare Business Relationships

By: Susan E. Ziel and Thomas N. Hutchinson on December 3, 2018

Since 2003, the Department of Health and Human Services’ Office of Inspector General (“OIG”), often partnering with other healthcare related organizations such as the American Health Lawyers’ Association and the Health Care Compliance Association, have authored a series of publications for…

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Proposed Regulations Allowing for Expanded Usage of Health Reimbursement Arrangements (HRAs) - Another Step In President Trump's Focus on Health Care Reform

November 18, 2018

A trifecta federal agency approach to expansion efforts related to health reimbursement arrangements (“HRAs”) occurred on October 29, 2018. The Departments of Treasury, Health and Human Services, and Labor (collectively, the “Departments”) jointly announced proposed HRA regulations, effective for…

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HIPAA Business Associates … How Do I Know Thee?

By: Susan E. Ziel and Robert A. Anderson on November 18, 2018

HIPAA, as amended by HITECH, imposes significant requirements on those persons or entities who constitute a business associate as a result of their access to protected health information in the performance of services on behalf of a covered entity.[1] 

For example, a business associate could be a…

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