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CMS Reminds Providers to Report Changes in Ownership

By: Thomas N. Hutchinson on March 4, 2018

CMS’ recent MLN Connects e-Newsletter reminds providers of their obligation to report changes in ownership to CMS and highlighted the 2016 Office of Inspector General (“OIG”) study that revealed providers may not be properly reporting changes in ownership.

OIG’s 2016 study titled “Medicare:…

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Continuing HIPAA Obligations After a Business Ceases

By: Stephanie T. Eckerle and Meghan M. Linvill McNab on March 4, 2018

In a recent announcement by the U.S. Department of Health and Human Services (“HHS”), Office of Civil Rights (“OCR”), the OCR was clear to make a point that just because a business closes during an OCR investigation, does not mean that the business’ obligation for any HIPAA violations ends.  To make…

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OIG Approves of Hospital-Physician Gainsharing Arrangement, But Details Prove Critical

By: Brian M. Heaton on March 4, 2018

A December 2017 Office of Inspector General (“OIG”) Advisory Opinion favors a gainsharing arrangement whereby a hospital will share with specific neurosurgeons a percentage of the hospital’s cost savings from spinal surgeries performed at the hospital. [1]  This Advisory Opinion marks the OIG’s…

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Passing of Bi-Partisan Budget Act Affects Medicaid Payments

By: Leah S. Mannweiler and Meghan M. Linvill McNab on February 25, 2018

On February 9, 2018, both the House and the Senate voted to pass, and President  Trump signed into law, the Bi-Partisan Budget Act of 2018 (the “Act”, House Resolution 1892).  Most notably this Act extends federal appropriations through March 23, 2018, preventing government shutdown for another…

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Recent OCR Resolution Agreement and Corrective Action Plan ... Lessons Learned

By: Stephanie T. Eckerle and Susan E. Ziel on February 25, 2018

The Health and Human Services’ Office of Civil Rights (“OCR”) recently entered into yet another Resolution Agreement after investigating a serious breach incident involving the electronic protected health information (“e-PHI”) of over 2 million patients that was maintained by a Florida health care…

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Ability to Prescribe Buprenorphine Expanded to Mid-Level Practitioners

By: Stephanie T. Eckerle and Meghan M. Linvill McNab on February 25, 2018

On January 23, 2018, the U.S. Drug Enforcement Administration (“DEA”) issued a  final rule announcing another step to increase opioid addiction treatment.[1]  Effective January 22, 2018, nurse practitioners (“NP”) and physician assistants (“PA”) are eligible to become DATA-Waived "qualifying…

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OIG Settles Cases Involving Allegations of EMTALA Violations

By: Thomas N. Hutchinson on February 25, 2018

In December 2017, the Office of Inspector General (“OIG”) entered into settlement agreements with four hospitals to resolve allegations of violations of the Emergency Medical Treatment and Labor Act (“EMTALA”).[1]  EMTALA requires hospitals to provide an appropriate screening examination and…

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Dismissal of Non-Intervened Qui Tam Lawsuits

By: Marc T. Quigley and Thomas J. Costakis on February 1, 2018

A Department of Justice internal memo dated January 10, 2018 reflects a significant policy change regarding the DOJ’s election to dismiss certain qui tam lawsuits in which the government declines to intervene.  The Memo (a copy of which can be found here) notes that the number of qui tam actions…

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D.C. District Court Clarifies Lab Requirement for Establishing Medical Necessity

By: Stephanie T. Eckerle on February 1, 2018

A June 2017 decision by a federal district court in the District of Columbia determined that a reference laboratory cannot rely on the ordering physician’s determination to establish medical necessity for testing paid for under Medicare, Medicaid, or other federal health care programs.[1]  In…

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HIPAA Security...Integrity Matters

By: Stephanie T. Eckerle and Susan E. Ziel on February 1, 2018

The HIPAA Security Rule requires Covered Entities and their respective Business Associates to maintain certain Administrative, Physical and Technical safeguards to protect Electronic Protected Health Information (“e-PHI”).  Specifically, these safeguards are designed to ensure the Confidentiality,…

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Recent DOJ Settlements with Physician Groups

By: Meghan M. Linvill McNab on February 1, 2018

On December 19, 2017, the U.S. Department of Justice (“DOJ”) announced settlements with two separate physician groups, one in Texas and one in Pennsylvania relating to allegations that the groups received illegal remuneration in exchange for patient referrals to hospitals owned by the now-defunct…

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CMS Issues Guidance Regarding Texting Physician Orders

By: Stephanie T. Eckerle on January 9, 2018

A December 28, 2017 CMS memo to state surveyors clarifies CMS’ position as it relates to texting of orders by physicians or other health care providers as well as utilizing text messaging as a means of communication among the healthcare team.[1] In its memo, CMS holds that the practice of texting…

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