Legislation and Public Policy


Zocdoc Fees Get Anti-Kickback Approval
September 18, 2019 | Eric D. Fader | Fraud and Abuse | Legislation and Public Policy | Medicare and Medicaid
The online appointment booking service Zocdoc has received a favorable Advisory Opinion from the U.S. Department of Health and Human Services’ Office of Inspector General (OIG) confirming that Zocdoc’s new per-click or per-booking fee model does not violate the federal Anti-Kickback Statute (AKS). Without AKS concerns, Zocdoc may now allow Medicare, Medicaid, and other federal …
Read More
Kaiser to Present at PLI Life Sciences Program
September 17, 2019 | Rivkin Rounds Staff | Cybersecurity | Electronic Health Records | FDA | False Claims Act | Fraud and Abuse | Legislation and Public Policy | Litigation | Medical Devices and Wearables | Medicare and Medicaid | Pharmaceuticals | Private Insurers
On October 10, Rivkin Radler’s Jeff Kaiser will be a panelist at the Practising Law Institute (PLI) program, “Life Sciences 2019: Navigating Legal Challenges in the Drug and Device Industries.” Jeff will speak on “Enforcement Trends Impacting the Drug and Device Industries,” including developments under the False Claims Act, federal Anti-Kickback Statute, off-label promotion, and …
Read More
FCA Ruling: Proof of Falsity Needed to Show Fraud
September 16, 2019 | Geoffrey R. Kaiser | False Claims Act | Fraud and Abuse | Hospitals | Legislation and Public Policy | Litigation | Medicare and Medicaid
Last week, the 11th Circuit Court of Appeals handed down its long-awaited decision in United States v. AseraCare, Inc. The case, brought under the False Claims Act (FCA) and argued way back in March 2017, alleged that AseraCare, a for-profit multi-state hospice chain, had submitted false claims to the Medicare program for patients who were …
Read More
New Rule Augments CMS’s Fraud-Fighting Powers
September 13, 2019 | Eric D. Fader | Fraud and Abuse | Legislation and Public Policy | Medicare and Medicaid
On September 5, the Centers for Medicare & Medicaid Services (CMS) announced the issuance of a final rule that will allow the agency to deny or revoke a healthcare provider’s or supplier’s federal program enrollment if it is “affiliated” with another previously revoked organization. The rule had originally been proposed more than three years ago. …
Read More
HHS Issues Limited HIPAA Waivers in Hurricane Areas
September 12, 2019 | Eric D. Fader | Electronic Health Records | HIPAA | Legislation and Public Policy
As it had done for previous hurricanes, the U.S. Department of Health and Human Services (HHS) recently issued a HIPAA Bulletin providing for a limited waiver of HIPAA sanctions and penalties for covered entities in Puerto Rico, Florida, Georgia, South Carolina and North Carolina in the aftermath of Hurricane Dorian. Such waivers are primarily intended …
Read More
New Regs Issued for Vaccination Exemptions
August 28, 2019 | Ada Kozicz | Legislation and Public Policy
On August 16, the New York State Department of Health (DOH) announced the issuance of emergency regulations regarding medical exemptions for school vaccinations. The new regulations went into effect immediately upon their issuance. Historically, New York State provided two exemptions for state-mandated vaccinations, one for religious considerations and the other for medical reasons. In June …
Read More
CMS Adds Health Plan Ratings to ACA Exchanges
August 20, 2019 | Eric D. Fader | Affordable Care Act | Legislation and Public Policy | Medicare and Medicaid | Private Insurers
The Centers for Medicare & Medicaid Services (CMS) announced on August 15 that health plans offered on health insurance exchanges will be ranked using a five-star quality rating system for the 2020 plan year open enrollment period that begins on November 1, 2019. The ratings will appear on both state-based exchanges and the federal exchange, …
Read More
Medicare Physician Fee Schedule for 2020 Includes Telehealth Changes
August 15, 2019 | Eric D. Fader | Home Health | Legislation and Public Policy | Medicare and Medicaid | Telehealth
On July 29, the Center for Medicare and Medicaid Services (CMS) released its proposed revisions to the Medicare Physician Fee Schedule for 2020. The Proposed Rule was published in the Federal Register on August 14. CMS proposed to add three new codes for treatment of opioid use disorder to the list of services that are …
Read More
NY IPA Focuses on Social Determinants of Health
August 13, 2019 | Cassandra Rivais DiNova | Home Health | Legislation and Public Policy | Medicare and Medicaid | Private Insurers
On August 6, health insurer MVP Health Care announced an affiliation with Alliance for Better Health to address so-called social determinants of health in the Albany, New York area. The newly formed independent practice association (IPA), Healthy Alliance Independent Practice Association, is one of the first IPAs in the U.S. to focus exclusively on social …
Read More
NY DOH Revises Policy for ASC Approval
August 6, 2019 | Benjamin P. Malerba | Ada Kozicz | Hospitals | Legislation and Public Policy
The New York State Department of Health (DOH) recently revised its policy regarding the review and approval process for Certificate of Need (CON) applications for ambulatory surgery centers (ASCs). The DOH’s current public need criteria favor the approval of new ASCs because they allow patients to obtain safe, low-cost and convenient surgical services outside a …
Read More

Authors
show more

Get legal updates and news delivered to your inbox