Hospitals


OIG Issues Favorable Advisory Opinion on Hospital/Physician Joint Venture ASC
May 5, 2021 | Ada (Kozicz) Janocinska | Fraud and Abuse | Hospitals | Legislation and Public Policy
In a recent advisory opinion, the U.S. Department of Health and Human Services’ Office of Inspector General (OIG) concluded that certain investments by a health system, manager and physicians in an ambulatory surgery center (ASC) did not create a substantial risk of fraud and abuse under the federal Anti-Kickback Statute (AKS) even though the investments …
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Pandemic response, fraud and abuse top Biden’s enforcement priorities
March 31, 2021 | Rivkin Rounds Staff | COVID-19 | False Claims Act | Fraud and Abuse | HIPAA | Hospitals | Legislation and Public Policy | Litigation
A March 24 article in Wolters Kluwer’s Health Law Daily, “STRATEGIC PERSPECTIVES: Pandemic response, fraud and abuse top Biden’s enforcement priorities,” quoted healthcare industry experts who predict increased enforcement in the areas of fraud and abuse, False Claims Act (FCA) cases, and pandemic-related waivers. Rivkin Radler’s Robert Hussar was quoted in the article. Among Bob’s …
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Time For CEs, BAs to Take Right of Access Seriously
March 18, 2021 | Rivkin Rounds Staff | Electronic Health Records | Employer/Employee | HIPAA | Hospitals | Legislation and Public Policy | Litigation
A March 11 article in the Health Care Compliance Association’s Report on Patient Privacy, “In Wake of 16th OCR Settlement, Time For CEs, BAs to Take Right of Access Seriously,” discussed the Right of Access Initiative that the U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) has been pursuing since 2019. …
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False Claims Act Cases Poised to Jump Now and for Years to Come
March 4, 2021 | Rivkin Rounds Staff | Behavioral Health | False Claims Act | Fraud and Abuse | Hospitals | Litigation | Medical Devices and Wearables | Medicare and Medicaid | Pharmaceuticals
Rivkin Radler’s Evan H. Krinick wrote an article entitled “False Claims Act Cases Poised to Jump Now and for Years to Come” that was published in the March 5, 2021 issue of the New York Law Journal. The article discusses health insurance fraud cases in 2020 that involved kickbacks, provision of medically unnecessary services, and …
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HIPAA Right of Access Initiative Marches On
February 26, 2021 | Eric D. Fader | Electronic Health Records | HIPAA | Hospitals | Legislation and Public Policy | Litigation
For those providers who somehow missed or ignored the first 15 settlements in the series, the U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) recently announced that Sharp HealthCare, doing business as Sharp Rees-Stealy Medical Centers, agreed to pay a $70,000 fine for failing to provide a patient with timely access …
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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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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 | Cassandra Rivais DiNova | 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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Proposed HIPAA Modification Would Facilitate Care Coordination
December 17, 2020 | Eric D. Fader | Behavioral Health | COVID-19 | Electronic Health Records | HIPAA | Hospitals | Legislation and Public Policy | Private Insurers
A proposed rule released by the U.S. Department of Health and Human Services on December 10 would give healthcare providers more flexibility to share patients’ health information for certain purposes. The rule, titled “Proposed Modifications to the HIPAA Privacy Rule to Support, and Remove Barriers to, Coordinated Care and Individual Engagement,” would loosen HIPAA restrictions …
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New AKS Safe Harbors Finalized
December 3, 2020 | Geoffrey R. Kaiser | Electronic Health Records | Fraud and Abuse | Hospitals | Legislation and Public Policy | Medical Devices and Wearables | Medicare and Medicaid | Pharmaceuticals | Telehealth
The Office of Inspector General, Department of Health and Human Services (OIG) has finalized new safe harbors and modifications of existing safe harbors under the federal Anti-Kickback Statute (AKS) to reflect a policy priority favoring a value-based health care system that “pays for health and outcomes” and that will “remove potential barriers to more effective …
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