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D.C. District Court Invalidates Medicaid Work Requirements

By: and Brandon W. Shirley on April 8, 2019

D.C. District Court Judge James Boasberg invalidated Federally approved Medicaid work requirements in Kentucky and Arkansas and sent the question back to the Centers for Medicare and Medicaid Services (“CMS”) for further analysis. The March 27, 2019 decision is a legal setback for CMS and states…

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HIPAA, Individual Rights and Personal Representatives

By: Susan E. Ziel and on April 8, 2019

The Health Insurance Portability and Accountability Act of 1996, as amended by the Health Information Technology for Economic and Clinical Health or “HITECH” Act  (hereinafter “HIPAA”)1 establishes numerous obligations for HIPAA covered entities and business associates.  

One obligation, in…

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Going, Going, Gone - Important Medical Records Considerations for Physicians Planning to Close Their Practice

By: Susan E. Ziel and Stacy Walton Long on March 25, 2019

The Indiana Administrative Code, specifically 844 IAC, Article 5, establishes certain professional standards for physicians licensed in the State of Indiana. One particular section, 844 IAC 5-2-16, sets forth requirements governing the discontinuation of a physician’s practice due to retirement or…

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HIPAA Violation Leads to Criminal Conviction of Former Patient Coordinator

By: Robert A. Anderson and on March 19, 2019

A former Patient Information Coordinator (Patient Coordinator), previously employed with UPMC and its affiliate, Tri Rivers Musculoskeletal Centers (TRMC) in Mars, Pennsylvania, pleaded guilty to a charge of wrongfully disclosing health information, in violation of the Health Insurance Portability…

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Illinois Appeals Court Upholds Denial of Property Tax Exemption for Hospice Center

By: Kendall A. Schnurpel and Robert A. Anderson on March 10, 2019

In an opinion issued on February 25, 2019, the Illinois Appellate Court confirmed that a not-for-profit hospice provider was not entitled to a charitable use property tax exemption because it was not exclusively engaged in charity care. See Midwest Palliative Hospice and Care Center v. Constance…

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Tidying Up for 2019: Are Your Estate Planning Documents in Order?

By: Micah J. Nichols and Rodney S. Retzner on March 5, 2019

A new year means “New Year’s Resolutions.” Many people commit to financial resolutions for 2019, whether it is eliminating debt or creating a monthly budget. Unfortunately, they neglect their estate plans. Adding estate planning to your resolutions is important for a variety of reasons, whether you…

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Indiana Medicaid Finalizes Rule Affecting ABA Therapy Services

By: Stephanie T. Eckerle and Brandon W. Shirley on March 5, 2019

The Office of Medicaid Policy and Planning finalized a rule impacting applied behavioral analysis (ABA) Therapy services effective March 1, 2019. Affected services providers should review and revise business policies and practices to accommodate these new changes as applicable. Note that the final…

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How Does Your Organization's Medicare/Medicaid Overpayments Policy Compare?

By: Susan E. Ziel and Brandon W. Shirley on February 20, 2019

The process for dealing with Medicare or Medicaid overpayments is essential to any health care organization. The mishandling of overpayments can result in substantial corporate liability, including potential claims of wrongful retention of overpayments in violation of the False Claims Act. Every…

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OCR Breaks All-Time Record in 2018 with Final HIPAA Settlement for the Year

By: Stacy Walton Long and on February 17, 2019

The Health and Human Services Office of Civil Rights (“OCR”) recently entered into its final Resolution Agreement of 2018 to resolve HIPAA allegations involving Cottage Health, a California health system that serves patients throughout the state. Cottage Health provided notice of breaches of…

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OIG Issues Favorable Advisory Opinion on Waiver of Cost-Sharing Amounts for Charitable Pediatric Care

By: Marc T. Quigley and Andrew W. Breck on February 17, 2019

The OIG recently published favorable guidance in Advisory Opinion No. 19-01 regarding the waiver of cost-sharing amounts for charitable pediatric care in limited circumstances (“Arrangement”).  While OIG concluded that the pediatric clinic’s Arrangement could potentially generate prohibited…

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Are you ready for changes to Medicare Part D prescription requirements?

By: Stacy Walton Long and Brandon W. Shirley on February 4, 2019

In October of 2018, Congress passed the SUPPORT for Patients and Communities Act (“SUPPORT Act”), a measure attempting to address the opioid epidemic at the national level. Two sections of the SUPPORT Act specifically mandate changes that will likely affect most providers, including the electronic…

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Updates to the Office of Inspector General Work Plan and Compliance Website

By: Susan E. Ziel and Brandon W. Shirley on February 4, 2019

The Health and Human Services’ Office of Inspector General (“OIG”) has published an annual Work Plan for many years, which typically reported on current OIG audits and evaluations, in addition to certain legal and investigative efforts, that concerned compliance issues across the many industry…

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