The Health Information Technology for Economic and Clinical Health (HITECH) Act, passed as a part of the American Recovery and Reinvestment Act of 2009 (ARRA) (i.e., the Stimulus Bill), requires the development of regulations requiring certain covered entities to provide thorough notification in the cases where there has been a breach of unsecured protected health […]
The Michigan Medicaid False Claims Act (FCA) has been found by the Department of Health and Human Services (HHS) Office of Inspector General (OIG), which has the authority to make this determination, to meet the requirements of the Deficit Reduction Act (DRA). Section 6031 of the DRA creates a financial incentive for States to enact […]
“Red Flag Rules” enforcement has been delayed by the Federal Trade Commission (“FTC”) until August 1, 2009. On the eve of the scheduled May 1, 2009 enforcement date for the Red Flag Rules, the FTC announced that it is delaying the enforcement date until August 1, 2009. The purpose of this extension is to give […]
The Office of the Inspector General (the “OIG”) posted new Advisory Opinion 09-03 on April 30, 2009, which concerns an arrangement whereby three municipalities reciprocally waive the otherwise applicable cost-sharing obligations of individuals residing within each other’s borders when providing backup emergency medical services transportation. Based on the facts presented, the OIG concluded that: (i) […]
The new Secretary of the Department of Health and Human Services (“HHS”) has been confirmed. On Tuesday, April 28, 2009, by a vote of 65-31, the Senate confirmed Kansas governor Kathleen Sebelius as the new Secretary of HHS. Just hours later, in an Oval Office ceremony, Sebelius was sworn in. As stated by the HHS […]
Electronic health records could become a reality sooner than expected for more users, if a recent bill, introduced by Democratic Senator Jay Rockefeller of West Virginia on April 23, 2009, is passed. The Health Information Technology Public Utility Act of 2009 would facilitate the nationwide adoption of open source-based electronic health records (“EHR”). According to […]
The current legislative initiatives to restrict (or eliminate) the In-Office Ancillary Services Exception (the “IOASE”) under Stark is, by no means, a new phenomenon. Rather, over the years, CMS has received a substantial number of comments from interested groups whose economic interests are adversely affected by the IOASE. In fact, the amendments to the Anti-Markup […]
In an Open Letter to health care providers published March 24, 2009, the Office of Inspector General (“OIG”) refined its Self-Disclosure Protocol (“SDP”) to resolve matters giving rise to civil monetary penalties (“CMPs”) under the federal Stark law and Anti-Kickback Statute, initially addressed by way of Open Letter dated April 24, 2006. In order to […]
The American Recovery and Reinvestment Act (the “Act” or “Stimulus Package”) included important changes to the Consolidated Omnibus Reconciliation Act (“COBRA”). Generally speaking, COBRA allows workers who have lost employer-sponsored health insurance to retain coverage for a period of time. The Stimulus Package includes important provisions related to the cost of health insurance premiums. Generally […]
Recovery Audit Contractors (“RACs”), as other Medicare contractors, are authorized to audit only a small sample of a providers’ or suppliers’ records, and if the RACs find an overpayment, they will extrapolate the overpayment finding to the providers’ or suppliers’ patient population. If RACs engage in statistical sampling and extrapolation, RACs are entitled to keep […]
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