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OCR Breaks All-Time Record in 2018 with Final HIPAA Settlement for the Year

By: Stacy Walton Long and on February 17, 2019

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…

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OIG Issues Favorable Advisory Opinion on Waiver of Cost-Sharing Amounts for Charitable Pediatric Care

By: Marc T. Quigley and Andrew W. Breck on February 17, 2019

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…

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Are you ready for changes to Medicare Part D prescription requirements?

By: Stacy Walton Long and Brandon W. Shirley on February 4, 2019

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…

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Updates to the Office of Inspector General Work Plan and Compliance Website

By: Susan E. Ziel and Brandon W. Shirley on February 4, 2019

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…

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The HIPAA “Top Ten” For Health Care Board Members

By: Susan E. Ziel and Stacy Walton Long on January 23, 2019

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,…

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Conscience and Religious Freedom Division of the Office of Civil Rights Concludes California Violated Conscience Protection Laws

By: Robert A. Anderson on January 22, 2019

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…

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Indiana Proposes New Rule Impacting Pharmacy Reimbursement

By: Stephanie T. Eckerle and Brandon W. Shirley on January 22, 2019

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…

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HHS Seeks Comments on Changes to HIPAA to Promote Improved Care Coordination

By: Stephanie T. Eckerle and Andrew W. Breck on January 7, 2019

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…

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Indiana Medicaid Rule Changes to Expect for 2019

By: Meghan M. Linvill McNab and Brandon W. Shirley on January 7, 2019

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…

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Responding to Online Patient Reviews: Legal and Practical Considerations for Physicians

By: Thomas N. Hutchinson and on January 7, 2019

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…

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Failure to Terminate Access to PHI Leads to HIPAA Violation

By: Stacy Walton Long and on December 17, 2018

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…

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Expanded Medicaid Treatment Options for Individuals with Substance Use Disorder and Serious Mental Illness

By: Stacy Walton Long and Amanda K. Schipp on December 17, 2018

This fall there have been a variety of federal initiatives aimed at expanding treatment options to address substance use disorder and mental illness. In late October, President Trump signed into law a comprehensive bipartisan opioid and substance abuse bill (available here) aimed at prevention,…

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