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|Settlement a Harbinger of Escalating Stark Law Exposure for Physician Compensation?|
Rick L. Hindmand, Jane Pine Wood; McDonald Hopkins LLC;
September 2, 2014, previously published on August 29, 2014A cardiology group practice recently agreed to pay $1.3 million to resolve allegations that it violated the Stark federal physician self-referral law and the False Claims Act by paying its physicians under a compensation formula that considered their referrals for nuclear and CT scans. On Aug. 4,...
|September 22, 2014 Deadline for Business Associate Agreements|
Margaret Young Levi; Wyatt, Tarrant & Combs, LLP;
September 2, 2014, previously published on August 22, 2014The final HIPAA Omnibus Rule (Omnibus Rule), published in the Federal Register on January 25, 2013, substantially increased the privacy and security responsibilities of a “business associate” of a “covered entity”, as those terms are defined by the Health Insurance...
|Two Important Deadlines Approaching for Self-Insured Group Health Plans|
Casey K. Fleming, Leigh C. Riley; Foley & Lardner LLP;
September 1, 2014, previously published on August 26, 2014If you sponsor a self-insured group health plan, then November includes two important deadlines: (1) you must obtain a health plan identifier for your plan, and (2) you must report the number of participants for whom a transitional reinsurance fee is due.
|Healthcare Reform in the U.S. Territories; Prepayment of Taxes for Puerto Rico Retirement Plans|
Karen N. Brandon, Grace Huang Ristuccia; Ogletree, Deakins, Nash, Smoak & Stewart, P.C.;
September 1, 2014, previously published on August 28, 2014The summer of 2014 has brought further guidance for health plan coverage in the U.S. territories and for retirement plan coverage in Puerto Rico. Issuers and employer sponsors of Puerto Rico group health plans and employer sponsors of Puerto Rico retirement plans should review their plans to ensure...
|Massive Data Breach Affects 4.5 Million Patients in 29 States|
Dianne J. Bourque, Julia M. Siripurapu; Mintz, Levin, Cohn, Ferris, Glovsky and Popeo, P.C.;
September 1, 2014, previously published on August 20, 2014Community Health Systems, Inc. (the “Company”), one of the largest hospital organizations in the country, announced via a public filing (Form 8K) made yesterday with the Securities and Exchange Commission (“Report”) that the Company was the target of a cyber attack that...
|Eleventh Circuit Rejects Constitutional Challenge to Statute Requiring Medicare Rate Compensation for Services|
F. Ryan Waters; GrayRobinson, P.A.;
September 1, 2014, previously published on August 28, 2014On August 14, 2014, a three judge panel for the Eleventh Circuit Court of Appeals upheld a district court's dismissal of a small, rural hospital's challenge of a federal law requiring hospitals to accept the Medicare rate as compensation when treating federal detainees.
|The Real Asbestos Fraud|
Brayton Purcell LLP;
September 1, 2014, previously published on August 26, 2014The great disingenuous that accompanies much of the asbestos industries attempt to defend the indefensible arises from the fact that because individual asbestos fibers are so small, less than 0.02 microns in diameter, and are a mineral fiber and not technically "manufactured," they didn't...
|Resistance WAS Futile—California Conforms to ACA Waiting Period Requirement|
Timothy G. Verrall; Ogletree, Deakins, Nash, Smoak & Stewart, P.C.;
August 29, 2014, previously published on August 20, 2014After wandering in the wilderness for a year, California has now come in from the cold and conformed its requirements for eligibility waiting periods to the federal standard adopted in the Affordable Care Act (ACA). Effective January 1, 2015, SB 1034 imposes a 90-day limit on eligibility waiting...
|Bundled Discounts Subject to Section 1/Clayton 3 Scrutiny In the Absence of Market Power and Substantial Foreclosure?|
Bruce A. Colbath; Sheppard, Mullin, Richter & Hampton LLP;
August 28, 2014, previously published on August 25, 2014Bundled discount programs have received significant antitrust scrutiny over the past decade, even though these marketing programs may benefit both consumers and competition. Typically, bundled discounts have been evaluated as either exclusive dealing or tying arrangements under Section 1 of the...
|OIG Finds Risk of Abuse in Specialty Pharmacy’s Per-Fill Fee Proposal|
Rachel Irving Pitts; Mintz, Levin, Cohn, Ferris, Glovsky and Popeo, P.C.;
August 28, 2014, previously published on August 22, 2014In an Advisory Opinion posted August 15, 2014, the Office of Inspector General (“OIG”) concluded that a proposed arrangement by a specialty pharmacy (“Requestor”) might generate prohibited remuneration under the Federal anti-kickback statute and would pose a risk of fraud...