Legislation and Public Policy


Warning: OCR HIPAA Audits Reveal Widespread Noncompliance
December 23, 2020 | Eric D. Fader | Electronic Health Records | HIPAA | Legislation and Public Policy | Litigation | Private Insurers
The U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) recently released an audit report on HIPAA compliance by 166 covered entities and 41 business associates during 2016-2017. The audits included detailed on-site reviews of entities’ documentation and implementation of HIPAA rules. The release of the report may foreshadow increased enforcement activities …
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NY Updates Guidance for Nursing Home Visits
December 21, 2020 | Wendy Hoey Sheinberg | Stephanie R. Yafeh | COVID-19 | Legislation and Public Policy | Nursing Homes
Spending time with family is always important, especially during the holiday season. The holidays are different this year, due to the pandemic, and spending time with loved ones in skilled nursing facilities requires additional planning. In response to recent spikes in Covid-19 cases in skilled nursing facilities, the New York Department of Health in November …
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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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Medicare Physician Fee Schedule Expands Telehealth Coverage
December 11, 2020 | Eric D. Fader | Legislation and Public Policy | Medicare and Medicaid | Telehealth
The 2021 Physician Fee Schedule (PFS) final rule recently released by the Centers for Medicare & Medicaid Services (CMS) includes the addition of 60 new telehealth services that will be covered and reimbursed by Medicare. The new services will allow Medicare beneficiaries to have greater access to telehealth, with a particular focus on residents of …
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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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Final Stark Law and Anti-Kickback Rules Released
November 24, 2020 | Eric D. Fader | Fraud and Abuse | Legislation and Public Policy | Medicare and Medicaid
On November 20, the Centers for Medicare & Medicaid Services (CMS) and the Department of Health and Human Services’ Office of Inspector General (OIG) announced the issuance of long-awaited final rules to modernize the Stark Law and federal Anti-Kickback Statute (AKS). Proposed changes, intended to promote value-based arrangements for providers and coordinated care for patients, …
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OIG Issues Special Fraud Alert on Speaker Programs
November 20, 2020 | Eric D. Fader | Fraud and Abuse | Legislation and Public Policy | Litigation | Medical Devices and Wearables | Medicare and Medicaid | Pharmaceuticals
The U.S. Department of Health and Human Services’ Office of Inspector General (OIG) issued a Special Fraud Alert on November 16, warning that speaker programs organized by pharmaceutical and medical device companies pose inherent fraud and abuse risks. OIG is “skeptical about the educational value of such programs” and cautioned that remuneration to referring practitioners …
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Significant Changes to Simplify the OMIG Annual Compliance Certification Process
November 10, 2020 | Ashley (Osadon) Algazi | Legislation and Public Policy | Medicare and Medicaid
The New York State Office of the Medicaid Inspector General (OMIG) instituted changes to its annual compliance certification process, effective immediately. These changes apply to those Medicaid, Managed Medicaid, and Service Bureau providers subject to the mandatory compliance program requirements in Section 363-d of the New York State Social Services Law (SSL) and the Deficit …
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New Relief Funds; Eased Lending Terms for Accelerated Payments
October 30, 2020 | Rivkin Rounds Staff | Behavioral Health | COVID-19 | Hospitals | Legislation and Public Policy | Medicare and Medicaid | Nursing Homes
An October 22 article in Part B News, “Welcome third round HHS relief funds, eased lending terms for accelerated payments,” discussed the Centers for Medicare & Medicaid Services’ Accelerated and Advance Payment Program (recently discussed here) and the Department of Health and Human Services’ CARES Act Provider Relief Program (recently discussed here). Rivkin Radler’s Eric …
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NY Spine Settles HIPAA Right of Access Violation for $100K
October 27, 2020 | Eric D. Fader | Electronic Health Records | HIPAA | Legislation and Public Policy | Litigation
The U.S. Department of Health and Human Services’ Office for Civil Rights’ HIPAA Right of Access Initiative has claimed another victim. HHS announced on October 9 that NY Spine Medicine, a private neurology and pain management practice with offices in Manhattan and Miami Beach, agreed to pay a $100,000 penalty for failing to provide patients …
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