Health Law

Published on: May 29, 2012 | by The Health Law Partners

Automated Tracking and Reporting of Recovery Audit-Associated Reopenings and Appeals

Changes to Recovery Audit Contractor (“RAC”) tracking and reporting of RAC-associated reopenings and appeals data were recently implemented. Specifically, CMS Transmittal 1093, dated May 23, 2012, deleted Business Requirement 7604.2.4, required under Change Request (“CR”) 7469, which mandated specific data transfer protocols related to the information. The Business Requirement was deleted due to RAC-data warehouse […]

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Published on: May 26, 2012 | by The Health Law Partners

State Attorney General-Initiated HIPAA Settlement Nets $750,000

The Massachusetts Attorney General’s Office announced Thursday that it has settled, for $750,000, a data breach lawsuit filed against South Shore Hospital under the Massachusetts Consumer Protection Act and the federal Health Insurance Portability and Accountability Act (HIPAA). The alleged HIPAA violation arose from unencrypted back-up tapes that South Shore sent offsite to a data […]

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Published on: May 4, 2012 | by The Health Law Partners

Government Criticizes Healthcare Providers and Insurers for Out-of-Network Payment

The New York State Department of Financial Services (“Department”) recently issued a highly critical report about out-of-network billing practices in New York State. The report stems from the Department’s receipt of frequent complaints from patients who unexpectedly receive bills from specialists or other providers who they did not know were out-of-network. The Department indicated that […]

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Published on: May 4, 2012 | by The Health Law Partners

CMS Delays Sunshine Act Data Collection Requirements

The Centers for Medicare and Medicaid Services (“CMS”) has extended the implementation of the Physician Payments Sunshine Act Physician Payments Sunshine Act (“Sunshine Act”), which was promulgated as a result of Section 6002 of the Patient Protection and Affordable Care Act. CMS will not require manufacturers of drugs, devices, biological, or medical supplies to begin […]

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Published on: May 2, 2012 | by The Health Law Partners

New CMS Guidance Allows SRDP Analysis to be Limited to Four Years

In four new recently posted frequently asked questions (FAQs) (select Fraud and Abuse in the left column), the Centers for Medicare & Medicaid Services (CMS) offers new guidance regarding the CMS Voluntary Self-Referral Disclosure Protocol. On September 23, 2010, CMS published the Medicare self-referral disclosure protocol (“SRDP”) pursuant to Section 6409(a) of the Patient Protection […]

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Published on: April 27, 2012 | by The Health Law Partners

Important Deadlines Looming for Healthcare Providers Who Treat Medicare Patients

In this rapidly-changing healthcare environment, providers need to remain cognizant of important deadlines that could affect their bottom lines. Here are several such deadlines under the Medicare program which could significantly impact cash flow. Saturday, June 30, 2012 – “E-Prescribing” – In order to qualify for an e-prescribing hardship exemption for calendar year 2013, eligible […]

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Published on: April 23, 2012 | by The Health Law Partners

Antitrust Lawsuit Against Blue Cross Blue Shield Dismissed

By an order dated March 30, 2012, the United States District Court for the Eastern District of Michigan dismissed an antitrust claim brought by the City of Pontiac against Blue Cross Blue Shield (BCBS), the largest private health insurance provider in Michigan. In the case of City of Pontiac v. Blue Cross Blue Shield of […]

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Published on: April 11, 2012 | by The Health Law Partners

New Hampshire House Passes Sweeping Rules Regarding Physician Relationships with Medical Device Companies

On March 29, 2012, with veritably no debate and less fan-fare, the New Hampshire House of Representatives recommended for passage HB 1725. HB 1725 is broad-reaching, and would prohibit all medical practitioners from prescribing or referring any FDA class II or class III implantable device in cases where they would gain profit, directly or indirectly […]

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Published on: April 2, 2012 | by The Health Law Partners

Significant Stark Law Case Overturned by the Fourth Circuit Court of Appeals

In an opinion issued March 30, 2012, the United States Court of Appeals for the Fourth Circuit overturned a $45 million judgment against Tuomey Healthcare System, Inc. (“Tuomey”), a private, nonprofit corporation which owns and operates Tuomey Hospital in Sumter County, South Carolina. A former physician brought a qui tam action against Tuomey alleging that […]

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Published on: March 28, 2012 | by The Health Law Partners

OIG Views Favorably a Proposal to Operate Website Containing Coupons and Advertising from Health Care Entities

On March 27, 2012, the Office of Inspector General (“OIG”) posted a favorable, but narrowly defined, Advisory Opinion (Opinion No. 12-02) pertaining to Requestor’s proposal to operate a website that would display coupons and advertising from health care providers, suppliers, and other entities (the “Proposed Arrangement”). Under the Proposed Arrangement, the Requestor, a corporation with […]

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