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…
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…
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…
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…
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…
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…
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,…
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…
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.…
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…
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…
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…
