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Articles Posted in Compliance

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OMIG Issues Guidance on Medicaid Compliance Requirements

The New York State Office of the Medicaid Inspector General (OMIG) issued guidance on its requirements for Medicaid compliance, effective October 26, 2016.  This Compliance Program Review Guidance (“Guidance”) will assist the Medicaid Required Provider (“Required Provider”) community in developing and implementing compliance programs that meet the requirements of Social…

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Health & Human Services (HHS) Release New Actions to Address Opioid Crisis

The United States Department of Health and Human Services has new actions planned to address the opioid crisis. The buprenorphine rule has been finalized, which allows physicians who have waivers to prescribe buprenorphine products (e.g., Suboxone) for up to 100 patients for 1 year or more to obtain a waiver…

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Phase 2 HIPAA audit notices are being issued

The HHS Office for Civil Rights (“OCR”) has begun issuing notices for Phase 2 HIPAA Audits applicable to covered entities and their business associates. In Phase 2, OCR will review the policies and procedures adopted and employed by covered entities and their business associates to satisfy standards and implementation specifications…

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Join Clinton Mikel of The Health Law Partners for Politico’s “Outside, In: Unhealthy Hacking: Medical Privacy in the Age of Cyber Attacks”

On Tuesday, May 10, 2016, Clinton Mikel, a Partner at The Health Law Partners and Chairman of the eHealth, Privacy and Security Interest Group of the American Bar Association Health Law Section, will be a guest speaker at Politico’s “Outside, In: Unhealthy Hacking: Medical Privacy in the Age of Cyber…

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OCR Launches Phase 2 of HIPAA Audit Program

The HHS Office for Civil Rights (“OCR”) has announced that it will begin the 2016 Phase 2 HIPAA Audit Program, the next phase of audits of covered entities and their business associates. In Phase 2, OCR will review the policies and procedures adopted and employed by covered entities and their…

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6th Circuit Court Ruling May Significantly Reduce Recoverable FCA Damages by Feds

In U.S. ex rel. Wall v. Circle C. Construction, Case #14-6150, 2016 WL 423750 (6th Cir. Feb. 4, 2016), the 6th Circuit Court held that damages in false certification cases should be based on the difference between the value of the items or services the government should have received and…

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Michigan Physicians Beware of Self-Prescribing & Prescribing for Family Members

Although there is no federal or state law barring physicians from providing health care services to themselves or their immediate family members including prescribing medication, there are limitations imposed by both applicable ethical rules and third party payor billing policies. For example, the American Medical Association (“AMA”) has Ethics Opinion…

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Providers Likely To Face Higher Penalties For Fraud and Regulatory Violations

On November 2, 2015 the President signed The Bipartisan Budget Act of 2015, requiring that civil monetary penalties must be raised to account for inflation, followed by an annual review for further increases. Providers accused of False Claims Act (FCA) violations are likely to see an increase as high as…