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Search OptionsHealth CareDismissal of Non-Intervened Qui Tam Lawsuits
A Department of Justice internal memo dated January 10, 2018 reflects a significant policy change regarding the DOJ’s election to dismiss certain qui tam lawsuits in which the government declines to intervene. The Memo (a copy of which can be found here) notes that the number of qui tam actions… D.C. District Court Clarifies Lab Requirement for Establishing Medical Necessity
A June 2017 decision by a federal district court in the District of Columbia determined that a reference laboratory cannot rely on the ordering physician’s determination to establish medical necessity for testing paid for under Medicare, Medicaid, or other federal health care programs.[1] In… HIPAA Security...Integrity Matters
The HIPAA Security Rule requires Covered Entities and their respective Business Associates to maintain certain Administrative, Physical and Technical safeguards to protect Electronic Protected Health Information (“e-PHI”). Specifically, these safeguards are designed to ensure the Confidentiality,… Recent DOJ Settlements with Physician Groups
On December 19, 2017, the U.S. Department of Justice (“DOJ”) announced settlements with two separate physician groups, one in Texas and one in Pennsylvania relating to allegations that the groups received illegal remuneration in exchange for patient referrals to hospitals owned by the now-defunct… CMS Issues Guidance Regarding Texting Physician Orders
A December 28, 2017 CMS memo to state surveyors clarifies CMS’ position as it relates to texting of orders by physicians or other health care providers as well as utilizing text messaging as a means of communication among the healthcare team.[1] In its memo, CMS holds that the practice of texting… Judge Allows Reduced 340B Payments, Effective 1/1/2018
CMS’ November 1, 2017 Outpatient Prospective Payment System (“OPPS”) Final Rule (the “Final Rule”) implemented sweeping changes to the 340B Discount Drug Program, including a 28.5% payment reduction in certain 340B covered entities’ Medicare Part B drug reimbursement. In response, three hospital… Professional Licensing Changes Benefit Indiana Professional Corporation
Beginning January 1, 2018, Indiana professional corporations (“PCs”) will no longer be required to apply for a certificate of registration or renew such certificate of registration with the Indiana Professional Licensing Agency (“PLA”). House Enrolled Act 1308 (“HEA 1308”) went into effect January… Highlights from the 2018 Physician Fee Schedule Final Rule
CMS published its 1,250 page 2018 Physician Fee Schedule Final Rule (“PFS”) on November 2, 2017.[1] In addition to the finalized changes to payment for non-excepted off-campus provider-based departments (discussed in detail here), the following are other important PFS changes, effective January 1,… 2018 CMS OPPS Final Rule Significantly Impacts 340B Covered Entities
340B covered entities are facing major changes in the way the discount drug program is reimbursed and administered. On November 1, 2017, CMS made available its 2018 Outpatient Prospective Payment System Final Rule (“Final Rule”).[1] The Final Rule implements, in total, drastic reimbursement cuts to… Important Non-340B Changes Finalized in 2018 CMS OPPS Final Rule
On November 1, 2017, CMS published its 2018 Outpatient Prospective Payment System OPPS Final Rule (“Final Rule”).[1] In addition to numerous changes to the 340B Discount Drug Program, the Final Rule finalizes other important rule changes requiring providers’ close consideration. Barring unexpected… Texas Medical Board Unveils New Rules to Expand Telemedicine
In May 2017, the Texas Senate passed Senate Bill 1107,[1] which cleared a path for the State’s various heath care professional boards, including the Texas Medical Board (“TMB”) and Texas State Board of Pharmacy (“TBP”), to offer greater, easier access to telemedicine services. On September 15,… Ohio Medical Board Issues Guidance On Ohio Telemedicine Prescribing Rule
The State Medical Board of Ohio recently issued a Frequently Asked Questions Guidance Document (“FAQ”) on Rule 4731-11-09 of the Ohio Administrative Code, which governs when a physician or physician assistant can prescribe medication to a patient that they have not conducted an in-person… |
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