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…
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…
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…
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…
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…
In furtherance of the many safeguards, both the HIPAA Privacy regulations, 45 CFR 164.530(b)(1), and the HIPAA Security regulations, 45 CFR 164.308(a)(5), require orientation and ongoing training programs for the Workforce. 45 CFR 160.103 defines “Workforce” to include all employees, volunteers,…
In 2015, California enacted the “Reproductive Freedom, Accountability, Comprehensive Care, and Transparency Act” (the “FACT Act”) requiring pregnancy centers to post notices in their facilities advising women that the State of California provided free or low-cost family planning services and…
The Indiana Family and Social Services Administration (“FSSA”) published a proposed rule that affects Medicaid reimbursement for legend and non-legend drugs. A public hearing about this rule is schedule for January 31, 2019 at 10:00am EST, and the FSSA is accepting public comments through that…
The U.S. Department of Health and Human Services (“HHS”) Office of Civil Rights (“OCR”) recently issued a Request for Information (“RFI”) to assist in identifying provisions of the Health Insurance Portability and Accountability Act (“HIPAA”) privacy and security regulations that could be revised…
An Executive Order limiting agency rulemaking has not prevented Indiana Medicaid from moving forward with a number of rulemaking changes expected to be finalized throughout 2019. These rules are in various stages of the rule adoption process, and have a broad impact on the health care community as…
In the age of immediate access to online platforms such as Google, Yelp, and Healthgrades, patients are able to share physician reviews, many of which are positive, but at times can be negative and potentially false. Negative reviews are damaging to a physician’s professional and personal…
The Health and Human Services’ Office of Civil Rights (“OCR”) recently entered into a Resolution Agreement with Pagosa Springs Medical Center (“PSMC”), resolving HIPAA violations over five years after the initial investigation began.1 On June 7, 2013, OCR initiated an investigation that revealed…
