Federal law penalizes a person who offers or gives a Medicare or Medicaid beneficiary any remuneration that it knows or should know is likely to influence the beneficiary’s selection of a specific provider, practitioner, or supplier of Medicare or Medicaid covered items or services. The OIG…
The United States Department of Health and Human Services, Office for Civil Rights (“HHS”) and the University of Massachusetts Amherst (“UMass”) recently entered into a Resolution Agreement and Corrective Action Plan to settle HIPAA violations resulting from the impermissible disclosure of…
On December 5, 2016, the OIG posted Advisory Opinion No. 16-12 concerning a laboratory’s proposal to provide the labeling of test tubes and specimens free of charge to dialysis facilities. One of the stated purposes of offering this free service was to “obtain or retain the business of a particular…
We previously published an article regarding the CMS proposed rule (published July 17, 2015) to revise the requirements that Long-Term Care (“LTC”) facilities must meet to participate in the Medicare and Medicaid programs, and its proposed changes to LTC facilities use of arbitration agreements.…
St. Joseph Health (“St. Joseph”), a nonprofit Catholic health care delivery system, purchased a new server to store files, including electronic Protected Health Information (“ePHI”), that incorporated a file sharing application. The default settings of the new server allowed anyone with an internet…
On September 8, 2016, the Centers for Medicare and Medicaid Services (“CMS”) finalized the Emergency Preparedness Rule (Final Rule”) for health care facilities. CMS has given significant attention to the Final Rule in light of the many major disasters that have occurred in the last ten years and…
Medicare Access & CHIP Reauthorization Act of 20151
On April 27, 2016, the Centers for Medicare and Medicaid Services (“CMS”) issued a Notice of Proposed Rulemaking to implement parts of the Medicare Access & CHIP Reauthorization Act of 2015 (“MACRA”). MACRA is part of an initiative…
The Franciscan Alliance and Christian & Medical Dental Associations joined six states in a lawsuit filed against Health and Human Services (“HHS”) in a Texas federal court on August 23, 2016, challenging the regulations that the HHS’ Office of Civil Rights (“OCR”) finalized this past May (“Final…
On July 17, 2015, CMS released a proposed rule to revise the requirements that Long-Term Care facilities must meet to participate in the Medicare and Medicaid programs. The proposed rule included a requirement regarding binding arbitration agreements. In the commentary CMS expressed concern that…
As many of you may know, the statewide home health reimbursement rates for Indiana Medicaid, are calculated based on the most recently completed Medicaid cost reports required from all home health providers billing Indiana Medicaid for services. (IHCP Bulletin 201625, May 17, 2016). As a result of…
The Balanced Budget Act of 2015 (“BBA”) passed on November 2, 2015 provides that, effective January 1, 2017, “applicable items and services” (other than items and services furnished by a dedicated emergency department) furnished by an off-campus outpatient department of a provider (“Off-Campus…
The Health and Human Services’ Office of Civil Rights (“OCR”) recently published a final Regulation (“Regulation”) that implements the nondiscrimination requirements of Section 1557 of the Patient Protection and Affordable Care Act.[1] Beginning on July 18, 2016, discrimination in health care…
