In order to maintain enrollment in Medicare, suppliers and providers must comply with Medicare program mandates, including the “enrollment requirements” detailed in Medicare’s conditions for payment regulations.[1] The enrollment requirements obligate a provider to submit – and keep current – a…
The Indiana Supreme Court recently held in Charles McKeen, M.D. v. Billy Turner that a plaintiff’s theory of negligence at trial need not be identical to the plaintiff’s theory in his or her submission to the Medical Review Panel (“Panel”), so long as evidence relating to the theories of…
Do you have a corporate policy that governs your "protected communications" which may be sent or received through the use of mobile devices? If yes, does your Policy address each of the following "Top 10" requirements? Here's a checklist to assist you in reviewing, updating (and communicating)…
The United States Department of Justice’s (“DOJ”) Fraud Section recently published guidelines (“Guidelines”) it will use when determining whether to bring charges against health care entities or individuals. While the Guidelines in no way represent an absolute defense against potential federal or…
On March 10, 2017 the Department of Health and Human Services, Office of Inspector General (“OIG”) published Advisory Opinion No. 17-01 regarding a hospital system’s proposal to provide free or reduced-cost lodging and meals to certain financially needy patients (“Proposed Arrangement”). The OIG…
President Trump’s March 16 “America First: A Budget Blueprint to Make America Great Again,” proposes to cut $15.1 billion in Department of Health and Human Services (“HHS”) spending, representing a nearly 18% reduction in annual spending.[1] The cuts target many entrenched programs and grants,…
HIPAA, as amended by HITECH, imposes significant requirements on those persons or entities who qualify as a business associate (BA) as a result of their access to protected health information (PHI) in the performance of services on behalf of a covered entity (CE).
For example, a BA could be a third…
The Health and Human Services Office of Inspector General (“OIG”) recently finalized new regulations (“Regulations”) impacting the anti-kickback statute (“AKS”) safe harbors and civil monetary penalties law (“CMPL”). Specifically, the Regulations expanded the exceptions and safe harbors under the…
Did your company have a HIPAA breach affecting less than 500 individuals in calendar year 2016 that has not yet been reported to HHS? If so, the deadline for submission of any breach notifications to HHS is March 1, 2017.
HIPAA requires that covered entities maintain a log or other documentation of…
The Health and Human Services Office of Inspector General (“OIG”) finalized Regulations on January 12, 2017, that revise and clarify Federal authorities governing a health care provider’s participation in and exclusion from a Federal health care program, i.e., Medicare and Medicaid. These changes…
On January 18, 2017, the Substance Abuse and Mental Health Services Administration (“SAMHSA”) published a Final Rule that updates the confidentiality requirements and provisions to improve the exchange of information of patients seeking treatment for a substance abuse disorder of 42 C.F.R. Part 2…
On January 27, 2017, CMS issued final guidance regarding implementation of its Medicare Outpatient Observation Notice (MOON) program. The MOON informs all Medicare beneficiaries (both traditional fee-for-service and Medicare Advantage) when they are an outpatient receiving observation services, and…
