Private Insurers


Self-Aware is Self-Defense: The Key to Good Corporate Compliance
August 31, 2021 | Rivkin Rounds Staff | False Claims Act | Fraud and Abuse | HIPAA | Hospitals | Legislation and Public Policy | Litigation | Medicare and Medicaid | Private Insurers
On Thursday, September 9, in the next installment of Rivkin Radler’s Healthcare Compliance Lunch & Learn series, Geoffrey R. Kaiser will present how to unearth compliance risks relating to: The federal Anti-Kickback Statute The Stark Law The False Claims Act The HIPAA Privacy Rule The presentation will focus on the kinds of questions organizations must …
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Federal Government Delays Enforcement of Price Transparency Rule
August 30, 2021 | Eric D. Fader | Affordable Care Act | Legislation and Public Policy | Pharmaceuticals | Private Insurers
The federal government will delay for six months its enforcement of key portions of the Transparency in Coverage (TiC) final rule that goes into effect on January 1, 2022. The change was announced in guidance issued jointly by the U.S. Departments of Labor, Health and Human Services, and the Treasury on August 20. The TiC …
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OIG Issues Favorable Advisory Opinion on Arrangement between Medigap Plan and Hospital Network
August 23, 2021 | Ada (Kozicz) Janocinska | Fraud and Abuse | Hospitals | Legislation and Public Policy | Medicare and Medicaid | Private Insurers
On August 16, the U.S. Department of Health and Human Services’ Office of Inspector General (OIG) issued a favorable Advisory Opinion regarding an arrangement between a Medicare Supplemental Health Insurance (“Medigap”) plan and a preferred hospital organization (PHO). The arrangement in question incentivized Medigap policyholders to seek inpatient care from hospitals that participated in the …
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Responding to Information Requests from Payors and Regulators
July 29, 2021 | Rivkin Rounds Staff | Electronic Health Records | Medicare and Medicaid | Private Insurers
On Thursday, August 12, in the next installment of Rivkin Radler’s Healthcare Compliance Lunch & Learn series, firm partners Christopher J. Kutner and John Queenan will discuss how to construct the proper response to information requests from third-party payors and regulators.  The presentation will cover: • State and federal agency requests • Payor requests (Medicare, …
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HIPAA Hot Topics: Right to Access, Third Party Authorizations, and Navigating Difficult Denials
April 23, 2021 | Rivkin Rounds Staff | Electronic Health Records | HIPAA | Legislation and Public Policy | Litigation | Private Insurers
Rivkin Radler’s Ashley Algazi and Eric Fader will be presenting at the Health Care Compliance Association’s New York Regional Healthcare Compliance Conference on May 7. The conference will be held virtually via Zoom. The presentation, titled “HIPAA Hot Topics: Right to Access, Third Party Authorizations, and Navigating Difficult Denials,” will include the following topics: Overview …
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OIG Warns on COVID-19 Vaccine Billing
April 20, 2021 | Eric D. Fader | COVID-19 | Legislation and Public Policy | Private Insurers
In an April 15 notice on its COVID-19 portal, the U.S. Department of Health and Human Services’ Office of Inspector General (OIG) reminded healthcare providers that COVID-19 vaccines must be administered at no out-of-pocket cost to patients. OIG has received complaints from patients that their providers charged them for COVID-19 vaccines. Under the Centers for …
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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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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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Tips for Buying the Right Malpractice Coverage
October 13, 2020 | Rivkin Rounds Staff | Litigation | Private Insurers
An October 9 article in Medical Economics, “Tips for buying the right malpractice coverage,” discussed factors physicians should consider when choosing a malpractice insurance policy. Rivkin Radler’s Chris Kutner was quoted in the article. Chris suggested that physicians compare policies from both commercial carriers and risk retention groups, which are liability insurance companies owned by …
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Anthem Agrees to $48 Million Multi-State Settlements Over 2014 Data Breach
October 9, 2020 | Ada (Kozicz) Janocinska | Cybersecurity | Electronic Health Records | HIPAA | Litigation | Private Insurers
Health insurer Anthem, Inc. has finally reached a settlement with a coalition of 41 states plus the District of Columbia, and a separate settlement with California, to resolve state attorney general investigations of a data breach that occurred in 2014. Anthem has agreed to pay the states a total monetary penalty of $48.2 million. The …
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