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NPDB Guidebook Changes

By: Brian M. Heaton and Meghan M. Linvill McNab on December 3, 2018

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…

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We May Finally Know Whether Being a Tricare Provider Makes One a Federal Contractor

By: Amy J. Adolay and Brandon W. Shirley on December 3, 2018

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…

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Important Organizational Safeguards to Manage Healthcare Business Relationships

By: Susan E. Ziel and Thomas N. Hutchinson on December 3, 2018

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…

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Proposed Regulations Allowing for Expanded Usage of Health Reimbursement Arrangements (HRAs) - Another Step In President Trump's Focus on Health Care Reform

November 18, 2018

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…

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HIPAA Business Associates … How Do I Know Thee?

By: Susan E. Ziel and Robert A. Anderson on November 18, 2018

HIPAA, as amended by HITECH, imposes significant requirements on those persons or entities who constitute a business associate as a result of their access to protected health information in the performance of services on behalf of a covered entity.[1] 

For example, a business associate could be a…

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Managed Care Proposed Rule Summary

By: Meghan M. Linvill McNab and Amanda K. Schipp on November 18, 2018

On November 8, 2018, the Centers for Medicare and Medicaid Services ("CMS") published a proposed rule aimed at Medicaid managed care. CMS indicated its intentions to streamline the managed care framework and relieve regulatory burdens created in the existing managed care regulations, which were…

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Upcoming INSPECT Compliance Dates

By: Thomas N. Hutchinson on October 28, 2018

Governor Eric Holcomb signed Senate Enrolled Act 221 (“SEA 221”) into law on March 22, 2018, which updated INSPECT requirements for practitioners with a controlled substance registration (“CSR”) in Indiana.  Notably, several of the bill’s requirements are effective January 1, 2019.

Under SEA 221, all…

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Lights, Camera, Sanction

By: Stephanie T. Eckerle and Stacy Walton Long on October 25, 2018

An ABC television crew was permitted to film on the premises of three Boston-area teaching hospitals, Boston Medical Center (“BMC”), Brigham and Women’s Hospital (“BWH”), and Massachusetts General Hospital (“MGH”). However, the three healthcare providers failed to first obtain patient…

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New CMS Proposed Rule - Reducing Regulatory Burden For Healthcare Providers

By: Stephanie T. Eckerle and Susan E. Ziel on October 8, 2018

On September 17, 2018, the Centers for Medicare and Medicaid Services "CMS" published a proposed rule to reduce burdensome regulations affecting healthcare providers as part of its "Patients Over Paperwork" initiative which began in 2017.   More information about the Patients Over Paperwork…

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Indiana Medicaid publishes a proposed rule overhauling its Medicaid program integrity requirements

By: Brandon W. Shirley and Amanda K. Schipp on October 7, 2018

On October 4, 2018, the Indiana Family and Social Services Administration published a proposed rule (“LSA #18-251”) that overhauls its Medicaid program integrity requirements. LSA #18-251 revises, clarifies, and adds new provisions affecting nearly all business aspects for Indiana Medicaid…

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Trump Administration Makes Changes to Appointment of Federal Administrative Law Judges

By: Libby Yin Goodknight and Brandon W. Shirley on September 18, 2018

On July 10, 2018, President Trump signed an Executive Order (“EO”) that altered the manner in which Federal Administrative Law Judges (“ALJ”) are selected for service from competitive examination and competitive service selection procedures to agency appointments. The changes in the EO were…

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OIG Advisory Opinion No. 18-08: Fire Departments' Mutual Aid Agreements

By: Thomas N. Hutchinson on September 18, 2018

On August 7, 2018, the Office of Inspector General (OIG) issued Advisory Opinion No. 18-08, which evaluated a proposal by six government-operated fire departments (the “Departments”) to enter into a mutual aid agreement to provide unscheduled, backup emergency ambulance services (“Backup Services”)…

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