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Adobe PDFOffice of Civil Rights Ready to Launch HIPAA Audits
Morris Polich Purdy LLP;
Legal Alert/Article
July 17, 2014, previously published on July 8, 2014
The Office of Civil Rights (OCR) of the United States Department of Health and Human Services (HHS) has completed its pilot program and is this year rolling out audits to assess compliance with the Health Information Portability & Privacy Act (HIPAA). All Covered Entities and Business...

 

HTMLThe Affordable Care Act—Countdown to Compliance for Employers, Week 24: Can Offers of Group Health Plan Coverage Under Code Section 4980H Qualify as “Bona Fide Fringe Benefits” for Service Contract Act Purposes?
Alden J. Bianchi; Mintz, Levin, Cohn, Ferris, Glovsky and Popeo, P.C.;
Legal Alert/Article
July 17, 2014, previously published on July 15, 2014
The Employer Shared Responsibility provisions of the Affordable Care Act (“ACA”) generally require “applicable large employers” (i.e., employers who employed at least 50 full-time and full-time equivalent employees on business days during the preceding calendar year) to...

 

HTMLCMS Proposes Changes to Sunshine Act Reporting
Kate F. Stewart; Mintz, Levin, Cohn, Ferris, Glovsky and Popeo, P.C.;
Legal Alert/Article
July 17, 2014, previously published on July 9, 2014
Drug and device manufacturers breathing a sigh of relief after completing their 2013 data submissions under the Physician Payment Sunshine Act (the “Sunshine Act’) must now contend with four proposed changes to the Sunshine Act regulations. On July 3, 2014 the Centers for Medicare &...

 

HTMLOIG Issues Special Fraud Alert on Laboratory Payments to Referring Physicians
Eric A. Klein, Rachel Landauer; Sheppard, Mullin, Richter & Hampton LLP;
Legal Alert/Article
July 17, 2014, previously published on July 8, 2014
The Health and Human Services Office of the Inspector General (OIG) recently issued a Special Fraud Alert on laboratory payments to referring physicians. Specifically, the alert is concerned with Specimen Processing Arrangements and Registry Arrangements, which OIG believes pose substantial risks...

 

Adobe PDFFDA Promises Guidance on Lawful Off-Label Promotion
Michael F. Buchanan, William F. Cavanaugh, Joshua A. Goldberg, Erik Haas, Daniel S. Ruzumna; Patterson Belknap Webb & Tyler LLP;
Legal Alert/Article
July 17, 2014, previously published on June 2014
Earlier this month, the U.S. Food and Drug Administration (the “FDA”) announced that by the end of the year, the agency would issue a draft guidance document addressing the contours of lawful and unlawful off-label promotion. The healthcare industry has heralded this announcement as a...

 

HTMLExclusion Screening: How Much is Enough?
Chris M. Morrison; GrayRobinson, P.A.;
Legal Alert/Article
July 17, 2014, previously published on July 9, 2014
Federal law prohibits payment by federal health care programs for items or services furnished by an excluded person, or at the medical direction or on the prescription of an excluded person. Employing or contracting an excluded person to provide items or services payable by federal health care...

 

HTMLCMS Seeks to Update Payment Rates and Eligibility Certification Requirements in Proposed Rule for Medicare Home Health Services
Eric A. Klein, Rachel Landauer; Sheppard, Mullin, Richter & Hampton LLP;
Legal Alert/Article
July 17, 2014, previously published on July 7, 2014
On July 7, the Centers for Medicare and Medicaid Services (CMS) published a proposed rule updating Medicare’s Home Health Prospective Payment System payment rates for 2015.

 

Adobe PDFHIPAA Breach Notification Analysis Under the Omnibus Rule
Ray Quinney Nebeker P.C.;
Legal Alert/Article
July 17, 2014, previously published on July 2, 2014
The final Omnibus Rule ("Rule"), effective March 26, 2013, modified the HIPAA Privacy and Security Rules and increased the burden on Covered Entities and Business Associates in the area of breach notification.

 

HTMLInsurer’s Motion to Dismiss Hospital’s Bad Faith Breach of Contract Claim Denied (New Jersey Federal Court)
Fineman Krekstein Harris P.C.;
Legal Alert/Article
July 17, 2014, previously published on July 8, 2014
In Conn. Gen. Life Ins. Co. v. Roseland Ambulatory Surgery Ctr., the plaintiff/counterclaim-defendant insurer brought claims against defendant/counterclaim-plaintiff hospital for failure to require patients to pay certain out-of-pocket expenses. The insurer originally brought a claim alleging that...

 

Adobe PDFCompliance In Health Care Is Not An Elective
Sally P. McDonald, Benjamin L. Rackliffe; Pannone Lopes Devereaux & West LLC;
Legal Alert/Article
July 16, 2014
The occurrence of health care fraud reached epidemic proportions in the United States during the late 1990s. As expected, the reaction by Congress was to pass legislation that significantly altered legal standards to make it easier for the federal government to prove violations of federally funded...

 


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