Legislation and Public Policy


NYS to Publicize Physician Misconduct Investigations
January 30, 2020 | Eric D. Fader | Fraud and Abuse | Legislation and Public Policy

New York Gov. Andrew Cuomo’s 2020 State of the State Agenda includes a proposal entitled “strengthening the oversight of physicians and other medical professionals to protect patients.” The proposal includes reforms to the procedures of the state Department of Health’s Office of Professional Medical Conduct (OPMC).

The most controversial portion of the proposal would allow

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NJ Bills Preserve ACA Protections
January 28, 2020 | Eric D. Fader | Affordable Care Act | Behavioral Health | Legislation and Public Policy | Private Insurers

New Jersey Governor Phil Murphy recently signed into law a package of nine bills that will preserve for state residents many of the provisions of the Affordable Care Act (ACA) even if the ACA itself is ultimately found unconstitutional. The new laws continue a trend among Democratic states that was previously discussed on Rivkin Rounds

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OIG Issues Advisory Opinion on Discounted Training
January 21, 2020 | Ada Janocinska | Fraud and Abuse | Hospitals | Legislation and Public Policy | Medicare and Medicaid

In a recent Advisory Opinion, the U.S. Department of Health and Human Services’ Office of Inspector General (OIG) approved a proposed arrangement whereby a hospital would offer discounted training to employees of one of the hospital’s referral sources, a local fire department.

The hospital is part of a non-profit health system that offers clinical training

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Updated Guidance Addresses the Privacy of Student Records
January 13, 2020 | Margarita Christoforou | Behavioral Health | Electronic Health Records | HIPAA | Legislation and Public Policy

In an effort to provide further clarity to school administrators, healthcare professionals and families, the U.S. Department of Education and the Office for Civil Rights at the U.S. Department of Health and Human Services recently released updated joint guidance addressing the application of the Family Educational Rights and Privacy Act (FERPA) and the HIPAA Privacy

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NY Deadline Approaching to Certify Compliance Programs
December 9, 2019 | Rivkin Rounds Staff | Fraud and Abuse | Home Health | Hospitals | Legislation and Public Policy | Medicare and Medicaid

The annual December 31st deadline for certain Medicaid providers and third-party billers to certify as to the effectiveness of their compliance program is fast approaching.

New York State Medicaid providers and third-party billing companies who claim, bill, order or receive at least $500,000 in any consecutive 12-month period from the Medicaid Program or Managed Medicaid

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Fader Gives Perspective on HIPAA Enforcement for Healthcare Risk Management
December 4, 2019 | Rivkin Rounds Staff | Cybersecurity | Electronic Health Records | HIPAA | Hospitals | Legislation and Public Policy | Litigation

Eric Fader contributed to Healthcare Risk Management’s HIPAA Regulatory Alert, which appeared in the publication’s December 2019 issue. The Alert outlines the best practices that will help avoid common HIPAA violations. Eric discusses the events that might trigger a regulatory action and the kinds of violations that may affect the severity of the penalties and fines.

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FDA Warns 15 More Companies on CBD
November 26, 2019 | Eric D. Fader | Cannabis | FDA | Legislation and Public Policy | Pharmaceuticals

On November 25, the U.S. Food and Drug Administration announced the issuance of warning letters to 15 companies that it says are violating the Federal Food, Drug, and Cosmetic Act by selling cannabidiol (CBD) products. The FDA’s views on the recent CBD marketing frenzy have been no secret, as previously discussed here. The FDA also

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Class Action Claims Reinstated on “Adulterated” Dietary Supplements
November 25, 2019 | Marc S. Ullman | Cannabis | FDA | Legislation and Public Policy | Litigation | Pharmaceuticals

The 11th Circuit Court of Appeals recently reversed a Florida lower court decision that dismissed class action claims under the Florida Deceptive and Unfair Trade Practices Act, the Illinois Consumer Fraud and Deceptive Business Practices Act, and the New York General Business Law alleging that the defendants defrauded the putative class by selling adulterated dietary

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HHS Releases Price Transparency Rules
November 21, 2019 | Eric D. Fader | Hospitals | Legislation and Public Policy | Medicare and Medicaid | Private Insurers

On November 15, the U.S. Department of Health and Human Services (HHS) announced the release of two healthcare price transparency rules. One is a final rule requiring hospitals to make available online all standard charges for items and services, including discounted rates negotiated with third-party payers. The second is a proposed rule that would require

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Primary Care Payment Model Delayed to 2021
November 4, 2019 | Eric D. Fader | Hospitals | Legislation and Public Policy | Medicare and Medicaid | Private Insurers

The Center for Medicare & Medicaid Innovation, part of the Centers for Medicare & Medicaid Services, recently released its Request for Applications for the new “Primary Care First” payment model. The program will now begin in 2021 rather than the 2020 start date that was originally proposed in April, as discussed here. CMS said it

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