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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...

 

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the U.S. Food and Drug Administration (the “FDA”) announced that by the end of the year, the agency would issue a draft guidance document addressing the contours of lawful and unlawful off-label promotion.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...

 

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...

 

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.

 

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 PDFThe Brave New World of Patient Protection and Affordable Care
Gary R. Pannone; Pannone Lopes Devereaux & West LLC;
Legal Alert/Article
July 16, 2014
The Patient Protection and Affordable Care Act (ACA) has permanently changed the landscape for providers and purchasers within the health care industry. The domino effect has created a sense of urgency in the approach to purchasing, financing and utilization of health care all of which requires...

 

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...

 

HTMLTermination of the Dentist/Patient Relationship
Christina C. Hadley; Hall Booth Smith, P.C.;
Legal Alert/Article
July 15, 2014, previously published on June 23, 2014
Almost every practicing dentist has experienced a problem patient. He or she may skip appointments, have unrealistic expectations, fail to pay bills, or simply be noncompliant with recommended care and treatment. Under certain circumstances, a dentist has the right to terminate his or her...

 

Adobe PDFHealth Care is Not a Simple Matter - Understanding the Complexities in a Changing Environment
Gary R. Pannone; Pannone Lopes Devereaux & West LLC;
White Paper
July 15, 2014
Health care and health insurance are evolving and becoming increasingly more fragmented because of the enactment of the Patient Protection and Affordable Care Act (ACA). The Centers for Medicare and Medicaid Services (CMS) continues to administer Medicare for persons age 65 and older and works in...

 


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