EHR Vendor to Pay $18.25 Million to Resolve Kickback Allegations
January 29, 2021 | Eric D. Fader | Electronic Health Records | False Claims Act | Fraud and Abuse | Litigation | Medicare and Medicaid
The U.S. Department of Justice (DOJ) announced on January 28 that athenahealth Inc., a Massachusetts-based electronic health records (EHR) technology vendor, has agreed to pay $18.25 million to resolve allegations that it paid illegal kickbacks to generate sales of its EHR product, athenaClinicals. The settlement is the government’s latest reminder that marketing initiatives that are …
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CMS Clarifies RPM Reimbursement
January 28, 2021 | Eric D. Fader | Home Health | Legislation and Public Policy | Medical Devices and Wearables | Medicare and Medicaid | Telehealth
The Centers for Medicare & Medicaid Services (CMS) recently released corrections to its 2021 Physician Fee Schedule final rule that was published on December 28. Some of the corrections clarify reimbursement requirements for remote patient monitoring (RPM), which entails gathering and interpreting physiologic data from patients at home. The December 28 final rule had stated …
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Yet Another HIPAA Right of Access Settlement
January 21, 2021 | Eric D. Fader | Electronic Health Records | HIPAA | Hospitals | Legislation and Public Policy | Litigation
The U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) announced the 14th settlement in its ongoing HIPAA Right of Access Initiative. Banner Health, a Phoenix-based health system that operates 30 hospitals and many other healthcare facilities, agreed to pay $200,000 for failing to provide patients with timely access to their medical …
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HHS Rule Blocks Enforcement Actions Based Solely on Guidance
January 19, 2021 | Eric D. Fader | Legislation and Public Policy | Litigation | Medicare and Medicaid
On January 12, the U.S. Department of Health and Human Services (HHS) released a final rule on “Transparency and Fairness in Civil Administrative Enforcement Actions.” The rule, which was effective immediately, states that HHS can rely only on statutes and regulations in bringing civil enforcement actions. Standards set forth in agency guidance documents may not …
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NY Gov. Cuomo Proposes Expanded Telehealth Access
January 13, 2021 | Eric D. Fader | Behavioral Health | COVID-19 | Legislation and Public Policy | Medicare and Medicaid | Nursing Homes | Telehealth
In his 2021 State of the State Address on January 10, New York Governor Andrew Cuomo announced legislation to expand access to telehealth. The proposals will adjust reimbursement incentives to encourage telehealth, relax or eliminate outdated regulatory restrictions on the delivery of telehealth services, and establish training programs for patients and providers and other programs …
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Relief Bill Revamps COVID-19 Telehealth Program
January 8, 2021 | Ada (Kozicz) Janocinska | Behavioral Health | COVID-19 | Hospitals | Legislation and Public Policy | Telehealth
The most recent COVID-19 relief bill that was signed into law in December includes $250 million in new funding for the federal COVID-19 Telehealth Program, previously discussed here. The program was originally established in March, at the beginning of the pandemic, to help expand connectivity among patients and providers across the country. Telehealth has played …
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AOT Orders a Useful Tool during COVID Pandemic
January 7, 2021 | Frank P. Izzo | Behavioral Health | COVID-19 | Hospitals | Legislation and Public Policy
The pandemic has prompted the reallocation of hospital beds from psychiatric care to treatment of COVID patients. This has occurred as mental illness has been on the rise. To cope with the insufficient number of psychiatric beds, it is important for hospitals to curtail readmissions. An often-underutilized tool to do so is the assisted outpatient …
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Substance Abuse Center and CEO in $6 Million Medicaid Fraud Settlement
January 6, 2021 | Margarita Christoforou | Behavioral Health | False Claims Act | Fraud and Abuse | Litigation | Medicare and Medicaid
On December 21, New York State Attorney General Letitia James announced a $6 million settlement of a civil healthcare fraud lawsuit against A.R.E.B.A-Casriel, Inc. d/b/a Addiction Care Interventions Chemical Dependency Treatment Centers (ACI) and its former owner and CEO, Steven Yohay. ACI will pay $3 million and Yohay will pay an additional $3 million personally …
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