On January 24, 2013, the U.S. Attorney’s Office for the State of New Jersey unsealed a $12.5 Million Dollar settlement with Cooper Health System, headquartered in the Camden, New Jersey area, but serving regions of New Jersey, Pennsylvania and Delaware. The settlement was the result of cardiologist Nicholas DePace’s whistleblower…
Articles Posted in HLP News and Events
The Office for Civil Rights has just released the long awaited HIPAA “Omnibus Rules”
Stay tuned for many further developments – The Health Law Partners will be providing numerous valuable educational resources for its clients. The announcement and links are below. January 17, 2013 The U.S. Department of Health and Human Services (HHS) has announced a new rule to strengthen the privacy and security…
CMS Transmittals: Medicare Claims Processing Manual, 100-04, Trans. No. 2634, January 11, 2013–Internet Only Manual (IOM) Update to Payment for Medical or Surgical Services Furnished by CRNAs. This CR rescinds and fully replaces CR 8027, (Jan. 15, 2013)
CMS released Transmittal No. 2634 to update the Medicare Claims Processing Manual in connection with the changes to payment for medical and surgical services furnished by CRNAs. In particular: 140.4.3 – Payment for Medical or Surgical Services Furnished by CRNAs (Rev.2634, Issued: 01-11-13, Effective: 01-01-13, Implementation: 02-12-13) B3-16003.H Payment shall…
American Sleep Medicine Agrees to Pay $15.3 Million for Improperly Billing Sleep Tests to the Government
According to the US Department of Justice, Florida-based American Sleep Medicine LLC has agreed to pay the government approximately $15,300,000 to resolve allegations that it billed Medicare and other government payors for diagnostic sleep services that were not eligible for payment. The payment settles a qui tam or False Claims…
HHS Announces First Settlement for Breach of HIPAA Privacy Rule Involving Fewer Than 500 Individuals
A press release from the U.S. Department of Health and Human Services (“HHS”) published on January 2, 2013 announced that the Department had reached its first settlement with a covered entity for a breach of the Health and Information Portability and Accountability Act (“HIPAA”) Privacy Rule affecting fewer than 500…
Medicare Doc-Fix Offsets Include Reduced Payments for Advanced Imaging
As part of the deal to avert the fiscal cliff that was passed on New Year’s Day, Congress extended the 2012 Physician Fee Schedule (“PFS”) through December 31, 2013, effectively freezing implementation of the Sustainable Growth Rate (“SGR”) formula that would have decreased Medicare physician payments by 26.5%. To pay…
Congress enacts “Doc Fix” as part of a Last Minute Bill to avoid the Fiscal Cliff
Late in the evening New Year’s Day, the House of Representatives passed a Senate Bill that avoids the fiscal cliff by making middle-class tax rates permanent and postponing automatic spending cuts for two months. As part of the deal, Congress included a Medicare “Doc Fix” necessary to avert a 26.5%…
New York ACO Law Amended
New York State Governor Andrew Cuomo recently signed into law legislation that provides significant amendments to the state’s law governing accountable care organizations (“ACOs”). The new law became effective on October 3, 2012. New York’s ACO law, enacted in March 2011 as a demonstration program, provided that an entity that…
OIG Advisory Opinion Provides Guidance on Electronic Health Record Connectivity Arrangements
On December 19, 2012, The Office of Inspector General (“OIG”) published an advisory opinion (“OIG AO 12-20“) wherein the agency concluded it will not impose sanctions under the Anti-kickback Statute (“AKS”) on a Hospital (“Hospital”) for its proposal to provide a free electronic interface (“the Interface”) to community physicians and…
Hospital Employment of Surgeons on the Rise
It seems like every ten years or so the pendulum swings towards or away from physicians seeking employment from hospitals as opposed to heading off on their own or joining existing private physician practices. Over the last few years, the pendulum has swung towards hospital employment. A number of factors…