A December 2017 Office of Inspector General (“OIG”) Advisory Opinion favors a gainsharing arrangement whereby a hospital will share with specific neurosurgeons a percentage of the hospital’s cost savings from spinal surgeries performed at the hospital. [1] This Advisory Opinion marks the OIG’s…
On February 9, 2018, both the House and the Senate voted to pass, and President Trump signed into law, the Bi-Partisan Budget Act of 2018 (the “Act”, House Resolution 1892). Most notably this Act extends federal appropriations through March 23, 2018, preventing government shutdown for another…
The Health and Human Services’ Office of Civil Rights (“OCR”) recently entered into yet another Resolution Agreement after investigating a serious breach incident involving the electronic protected health information (“e-PHI”) of over 2 million patients that was maintained by a Florida health care…
On January 23, 2018, the U.S. Drug Enforcement Administration (“DEA”) issued a final rule announcing another step to increase opioid addiction treatment.[1] Effective January 22, 2018, nurse practitioners (“NP”) and physician assistants (“PA”) are eligible to become DATA-Waived "qualifying…
In December 2017, the Office of Inspector General (“OIG”) entered into settlement agreements with four hospitals to resolve allegations of violations of the Emergency Medical Treatment and Labor Act (“EMTALA”).[1] EMTALA requires hospitals to provide an appropriate screening examination and…
A Department of Justice internal memo dated January 10, 2018 reflects a significant policy change regarding the DOJ’s election to dismiss certain qui tam lawsuits in which the government declines to intervene. The Memo (a copy of which can be found here) notes that the number of qui tam actions…
A June 2017 decision by a federal district court in the District of Columbia determined that a reference laboratory cannot rely on the ordering physician’s determination to establish medical necessity for testing paid for under Medicare, Medicaid, or other federal health care programs.[1] In…
The HIPAA Security Rule requires Covered Entities and their respective Business Associates to maintain certain Administrative, Physical and Technical safeguards to protect Electronic Protected Health Information (“e-PHI”). Specifically, these safeguards are designed to ensure the Confidentiality,…
On December 19, 2017, the U.S. Department of Justice (“DOJ”) announced settlements with two separate physician groups, one in Texas and one in Pennsylvania relating to allegations that the groups received illegal remuneration in exchange for patient referrals to hospitals owned by the now-defunct…
A December 28, 2017 CMS memo to state surveyors clarifies CMS’ position as it relates to texting of orders by physicians or other health care providers as well as utilizing text messaging as a means of communication among the healthcare team.[1] In its memo, CMS holds that the practice of texting…
CMS’ November 1, 2017 Outpatient Prospective Payment System (“OPPS”) Final Rule (the “Final Rule”) implemented sweeping changes to the 340B Discount Drug Program, including a 28.5% payment reduction in certain 340B covered entities’ Medicare Part B drug reimbursement.
In response, three hospital…
Beginning January 1, 2018, Indiana professional corporations (“PCs”) will no longer be required to apply for a certificate of registration or renew such certificate of registration with the Indiana Professional Licensing Agency (“PLA”).
House Enrolled Act 1308 (“HEA 1308”) went into effect January…
