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|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...
|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.
|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.
|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...
|Medicare to Pay for Chronic Care Management: Forbidden Fruit or Just What the Doctor Ordered?|
Marc I. Goldsand, Rick L. Hindmand; McDonald Hopkins LLC;
August 28, 2014, previously published on August 26, 2014Commencing in January 2015, Medicare will pay qualifying physicians, advanced practice registered nurses, physician assistants, clinical nurse specialists, and certified nurse midwives a chronic care management (CCM) flat (per patient) monthly fee to coordinate care for Medicare beneficiaries who...
|Another Court Weighs in on Rule 9(b)’s Requirements Under the False Claims Act|
Thomas S. Crane, Brian P. Dunphy, Laurence J. Freedman; Mintz, Levin, Cohn, Ferris, Glovsky and Popeo, P.C.;
August 28, 2014, previously published on August 27, 2014A federal district court recently dismissed a qui tam relator’s complaint in a declined case against the Hospital for Special Surgery (“Hospital”), its former CEO, and an outside billing company alleging that they violated the federal False Claims Act (FCA) and the New York FCA...
|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...
|CMS Care Coordination Payments - A Boon to Doctors and Patients but Patient Participation Will be Essential|
Vinay Bhupathy, Aytan Dahukey; Sheppard, Mullin, Richter & Hampton LLP;
August 27, 2014, previously published on August 19, 2014As the Affordable Care Act continues to mature, we are seeing new efforts by the Obama administration to incentivize care coordination across a spectrum of services provided to Medicare Fee-for-Service (FFS) patients. A New York Times article posted on August 16, 2014 reports that starting in...
|HIPAA Deemed Compliance Period Ends Next Month|
Deborah C. Hiser; Husch Blackwell LLP;
August 27, 2014, previously published on August 22, 2014The U.S. Department of Health and Human Services (HHS) issued final regulations in January 2013 modifying the privacy, security and enforcement provisions under the Health Information Portability and Accountability Act of 1996 (HIPAA). Covered entities and business associates were generally...
|Increase to Affordable Care Act Affordability Threshold|
Lamb Barnosky LLP;
August 27, 2014, previously published on August 21, 2014As we advised you in our February 19,2013 memorandum, the Affordable Care Act ("the ACA") includes a shared responsibility provision that potentially penalizes covered employers that do not offer affordable health insurance coverage to their full-time employees. The ACA regulations define...