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Search OptionsHealth CareManaged Care Proposed Rule Summary
On November 8, 2018, the Centers for Medicare and Medicaid Services ("CMS") published a proposed rule aimed at Medicaid managed care. CMS indicated its intentions to streamline the managed care framework and relieve regulatory burdens created in the existing managed care regulations, which were… Upcoming INSPECT Compliance Dates
Governor Eric Holcomb signed Senate Enrolled Act 221 (“SEA 221”) into law on March 22, 2018, which updated INSPECT requirements for practitioners with a controlled substance registration (“CSR”) in Indiana. Notably, several of the bill’s requirements are effective January 1, 2019. Under SEA 221, all… Lights, Camera, Sanction
An ABC television crew was permitted to film on the premises of three Boston-area teaching hospitals, Boston Medical Center (“BMC”), Brigham and Women’s Hospital (“BWH”), and Massachusetts General Hospital (“MGH”). However, the three healthcare providers failed to first obtain patient… New CMS Proposed Rule - Reducing Regulatory Burden For Healthcare Providers
On September 17, 2018, the Centers for Medicare and Medicaid Services "CMS" published a proposed rule to reduce burdensome regulations affecting healthcare providers as part of its "Patients Over Paperwork" initiative which began in 2017. More information about the Patients Over Paperwork… Indiana Medicaid publishes a proposed rule overhauling its Medicaid program integrity requirements
On October 4, 2018, the Indiana Family and Social Services Administration published a proposed rule (“LSA #18-251”) that overhauls its Medicaid program integrity requirements. LSA #18-251 revises, clarifies, and adds new provisions affecting nearly all business aspects for Indiana Medicaid… Trump Administration Makes Changes to Appointment of Federal Administrative Law Judges
On July 10, 2018, President Trump signed an Executive Order (“EO”) that altered the manner in which Federal Administrative Law Judges (“ALJ”) are selected for service from competitive examination and competitive service selection procedures to agency appointments. The changes in the EO were… OIG Advisory Opinion No. 18-08: Fire Departments' Mutual Aid Agreements
On August 7, 2018, the Office of Inspector General (OIG) issued Advisory Opinion No. 18-08, which evaluated a proposal by six government-operated fire departments (the “Departments”) to enter into a mutual aid agreement to provide unscheduled, backup emergency ambulance services (“Backup Services”)… Medicare Attempts Streamlining
As reported in CMS’s MLNConnects (click here for release), CMS recently proposed significant regulatory changes that would reduce the burden of Medicare paperwork and thereby increase the amount of time that physicians and other clinicians can spend with their patients. The proposed rules are… HIPAA Assessments... Here's Looking at You!
Whether you are the Privacy Officer, the Security Officer, or both, the question remains the same. When was the last time you scheduled a "walk through" of your work space for the sole purpose of looking into the "eyeballs" of your personnel and finding out what they are really doing (or not doing)… Clarification on Use of Documentation Assistants or Scribes
The Joint Commission (“JC”) recently released a new Standards FAQ (“FAQ”) setting forth guidelines that should be followed when physicians or other licensed independent practitioners (“LIPs”) use documentation assistants (referred to herein as “scribes”) to assist with documentation. In the FAQ,… OCR Issues Guidance on Disposing of Electronic Devices and Media
On August 7, 2018, the HHS Office of Civil Rights (OCR) issued guidance on disposing of electronic devices and media1. This guidance is important for all healthcare providers as it applies to any covered entities or business associates that store ePHI on desktops, laptops, copiers, cell phones, USB… HHS OIG Recommends Greater Efforts by Medicaid Managed Care Organizations in Identifying and Addressing Medicaid Fraud and Abuse
The Health and Human Services Office of Inspector General (“OIG”) published a report in July of 2018 (“Report”) regarding weaknesses by Medicaid Managed Care Organizations (“MCO”) to identify fraud and abuse in the Medicaid program1. In general, the OIG found that MCOs lacked the controls and… |
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