An Executive Order limiting agency rulemaking has not prevented Indiana Medicaid from moving forward with a number of rulemaking changes expected to be finalized throughout 2019. These rules are in various stages of the rule adoption process, and have a broad impact on the health care community as…
In the age of immediate access to online platforms such as Google, Yelp, and Healthgrades, patients are able to share physician reviews, many of which are positive, but at times can be negative and potentially false. Negative reviews are damaging to a physician’s professional and personal…
The Health and Human Services’ Office of Civil Rights (“OCR”) recently entered into a Resolution Agreement with Pagosa Springs Medical Center (“PSMC”), resolving HIPAA violations over five years after the initial investigation began.1 On June 7, 2013, OCR initiated an investigation that revealed…
This fall there have been a variety of federal initiatives aimed at expanding treatment options to address substance use disorder and mental illness. In late October, President Trump signed into law a comprehensive bipartisan opioid and substance abuse bill (available here) aimed at prevention,…
Indiana Medicaid announced that, effective January 1, 2019, adults determined to be presumptively eligible for Medicaid will receive fee-for-service benefits during the presumptive eligibility (PE) coverage period. This change means that the enhanced benefits and additional flexibilities previously…
The Health and Human Services’ Office of Civil Rights (“OCR”) recently entered into a Resolution Agreement with a Florida physicians’ group, Advanced Care Hospitalists PL (“ACH”), after investigating an alleged HIPAA breach.1 Between November 2011 and June 2012, ACH obtained billing data processing…
The Bipartisan Budget Act (“BBA”) of 2015, and its implementing regulations at 42 CFR 419.22(v) and 419.48 resulted in the movement of payments for nonexcepted provider-based departments (“PBD”) from the outpatient prospective payment system (“OPPS”) to the Medicare Part B site-specific Physician…
U.S. Deputy Attorney General Rod Rosenstein recently announced changes to criminal and civil corporate investigation protocol during a speech on November 29, 2018. For the past several years, the US Department of Justice (“DOJ”) has attempted to adhere to the Yates Memo, which focused on individual…
The US Department of Health & Human Services updated the National Practitioner Data Bank (“NPDB”) Guidebook, effective October 2018. The last time the Guidebook was revised was April 2015. While the 2015 revision included substantial updates to the regulatory scope, content and display of the…
The U.S. Department of Labor (DOL) recently announced plans to clarify application of federal anti-discrimination requirements on health care providers with Tricare enrollment agreements. The DOL and Tricare providers have long been at odds over whether a Tricare enrollment agreement made one a…
Since 2003, the Department of Health and Human Services’ Office of Inspector General (“OIG”), often partnering with other healthcare related organizations such as the American Health Lawyers’ Association and the Health Care Compliance Association, have authored a series of publications for…
A trifecta federal agency approach to expansion efforts related to health reimbursement arrangements (“HRAs”) occurred on October 29, 2018. The Departments of Treasury, Health and Human Services, and Labor (collectively, the “Departments”) jointly announced proposed HRA regulations, effective for…
