PREVENTING OVERPAYMENTS FROM BECOMING FALSE CLAIMS

By:  Andrew Sparks Overpayments to healthcare providers receiving Medicare reimbursements are at risk of civil and criminal enforcement action if not attuned to a particular reimbursement rule and diligent in compliance with the rule’s requirements. In short, the overpayment rule turns potential billing mistakes into fraud. A healthcare provider cannot keep money paid in error. …

Health System Paid $2.4 Million Settlement After Identification in a Press Release of a Patient Who Was Engaged in Fraud

By: Kimberly Ruppel The U.S. Department of Health and Human Services Office for Civil Rights (“OCR”) announced a $2,400,000 settlement with Memorial Hermann Health System (“MHHS”) to resolve an investigation of an unauthorized disclosure of protected health information (“PHI”) as a potential violation of the Privacy Rule of the Health Insurance Portability and Accountability Act …

Key Tax Changes in the American Health Care Act

By: Cyndi Moore  The American Health Care Act (“AHCA”), passed by the House of Representatives on May 4, 2017, repeals many of the taxes added by the Affordable Care Act (“ACA”) and makes changes to other tax rules.  Some of the notable changes proposed to be made to the Internal Revenue Code are:             1.         …

Practicing Telemedicine Across State Borders: New Expedited Licenses Permit Physicians to Expand Practice

By: Marki Stewart In a watershed moment for the expansion of telemedicine, the Interstate Medical Licensure Compact Commission is now processing applications to allow physicians to practice telemedicine across state lines with greater ease.  Nineteen states have passed legislation to adopt the Interstate Medical Licensure Compact, which allows physicians to obtain a license to practice …

Wireless Healthcare Services Provider’s $2.5m Settlement Demonstrates Why Understanding HIPAA Requirements Is a Must

By:  Sara Jodka The U.S. Department of Health and Human Services Office for Civil Rights (OCR) announced a $2.5 million Health Insurance Portability and Accountability Act of 1996 (HIPAA) settlement with CardioNet, which is a company that provides remote mobile monitoring of and rapid response to patients at risk for cardiac arrhythmias. The settlement is based …

Settlement Highlights Need for HIPAA-Covered Entities to Have Business Associate Agreements in Place with PHI Vendors

By:   Sara Jodka The Department of Health and Human Services’ Office for Civil Rights (ORC) announced an agreement to settle possible Health Insurance Portability and Accountability Act (HIPAA) violations with The Center for Children’s Digestive Health (CCDH).  This settlement is worth noting is because it highlights the need for HIPAA-covered entities to obtain signed HIPAA-compliant …

Caution as to Compensation Paid by Professional Corporations

By: Ralph Levy Of Counsel, Nashville   Two recent Tax Court cases raise caution flags as to the deductibility of shareholder compensation by medical, dental and other professional practice groups organized as professional corporations (PCs) or professional associations (PAs) that are taxed as “C” corporations for federal tax purposes.  In each case, on audit, the …

$400,000 Settlement Highlights Need for Pre- and Post-Breach Safeguards

By: Sara Jodka The U.S. Department of Health and Human Services, Office for Civil Rights (OCR), has announced another Health Insurance Portability and Accountability Act of 1996 (HIPAA) settlement. This one is with Metro Community Provider Network (MCPN), a federally-qualified health center (FQHC) that provides primary medical care, dental care, pharmacies, social work, and behavioral …

Telecommuting Healthcare Employees Get Employers in HIPAA Compliance Hot Water

By: Sara Jodka As the healthcare industry has expanded to providing home healthcare services, more service providers are allowing their employees to work remotely, i.e., telecommuting. The flexibility for healthcare workers to work from anywhere with an Internet connection has some advantages, but it also has many dangerous disadvantages. One specific disadvantage in the healthcare …