Health Care
By: Brandon W. Shirley
on February 13, 2024
As the conflict between 340B over the scope of the 340B drug discount program enters its fourth year, Covered Entities are increasingly turning to state law for relief from restrictions on contract pharmacies because Congress and federal agencies have been unable to make meaningful progress. The…
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By: Christopher J. Kulik and Stacy Walton Long
on February 13, 2024
Each year, entities regulated under HIPAA must report breaches affecting less than 500 individuals to the Department of Health and Human Services (“HHS”) within sixty days following the end of each calendar year. This means that the deadline to report to HHS these type of breaches occurring in 2023…
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By: Meghan M. Linvill McNab and Brandon W. Shirley
on February 13, 2024
CMS published a final rule, effective January 1, 2026, implementing additional processes to advance interoperability as well as to improve prior authorization processes. The changes to prior authorization will require: (1) Medicare Advantage, Medicaid Fee-for-Service (“FFS”) and Medicaid Managed…
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By: George C. Lepeniotis and Christopher J. Kulik
on January 4, 2024
In the digital age, where information is constantly being generated, the concepts of privacy are rapidly evolving, especially in the healthcare sector. This transformation has significant implications for both healthcare providers and patients.
In this episode of the Krieg DeVault Podcast…
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By: Brandon W. Shirley and Stacy Walton Long
on November 29, 2023
The United States Office of Inspector General (“OIG”) published a unified compliance resource tool on November 6, 2023. While the General Compliance Program Guidance (“GCPG”) does not provide new substantive content, it does provide a single source of information relating to some of the greatest…
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By: Stephanie T. Eckerle and Christopher J. Kulik
on November 29, 2023
On November 2, 2023, parties including the American Hospital Association (“AHA”) sued the U.S. Department of Health and Human Services (“HHS”) Office of Civil Rights (“OCR”) in a federal court in Texas. In their complaint they challenge the enforcement of an OCR guidance bulletin (the, “Bulletin”),…
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By: Meghan M. Linvill McNab and Brandon W. Shirley
on October 3, 2023
On August 2, 2023, CMS published the fiscal year 2024 Inpatient Psychiatric Facilities Prospective Payment System (“IPF PPS”) Final Rule. One of the included regulatory changes was to the permitted timing for a hospital to convert a rehabilitation or psychiatric unit from “non-excluded” to…
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By: Brandon W. Shirley and Meghan M. Linvill McNab
on August 16, 2023
The Centers for Medicare and Medicaid Services (“CMS”) recently suspended a key procedure for resolving payment disputes between out-of-network providers and health facilities against insurers under the No Surprises Act. The procedure is the Independent Dispute Resolution (“IDR”) process. It…
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By: Robert A. Anderson and Hillary N. Buchler
on July 6, 2023
The U.S. Department of Health and Human Services, Office for Civil Rights (“OCR”) recently concluded its investigation into Yakima Valley Memorial Hospital (“Yakima”). The matter illustrates the need to limit access to private health information (“PHI”) to those members of the workforce with a need…
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