By Keith C. Dennen A woman is seriously injured in a car accident. It is not her fault. She is taken to the emergency room where she is treated. When she is released, the hospital bills total $100,000. The woman has health insurance. The hospital submits its claim and the health insurance company pays $25,000.00 …
Before Your Nonprofit Health System Considers a Merger – Three Important Board Preps
By Jay Hughes The Governing Board of every nonprofit health system considering a merger, change in control, sale or significant affiliation has a key role in the process and needs to be engaged throughout the planning, research, evaluation, negotiation, finalization and implementation of any transaction. Good planning at the beginning of this process will better …
HHS Aggressive Goals for Value Based Payments
By Rose Willis In a brief article published last week in the New England Journal of Medicine, Sylvia Burwell, the U.S. Secretary of Health and Human Services (HHS), summarily set forth HHS’s efforts for improving the U.S. health care system. According to Ms. Burwell, these efforts will be focused on three methods: (1) using incentives …
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Attorney James Burns Speaks to Bloomberg BNA About Key Pharmaceutical Antitrust Topics for 2015
Dickinson Wright Member James Burns recently spoke to Bloomberg BNA’s Pharmaceutical Law & Industry Report for the article, “Biosimilars Policy, Accelerating Medical Breakthroughs Among Year’s Key Topics” (1/16/2015). In the article, Mr. Burns discusses some of the key antitrust issues for the upcoming year in the pharmaceutical industry. Mr. Burns noted that one significant issue …
Arrangements between Laboratories and Referring Physicians Involving “Registries”
By Rose Willis The United States Office of Inspector General (“OIG”) recently issued a “Special Fraud Alert” focusing on two potentially illegal trends that it has detected in arrangements between laboratories and their referring physicians: Specimen Processing Arrangements and Registry Payments. Specimen processing arrangements were the subject of an earlier blog post, “Laboratory Payments to …
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Connecticut Law Imposes New Merger Regulations on Physician Combinations
By James M. Burns and Jessica Russell On October 1, a first-of-its-kind law became effective in Connecticut that requires group medical practices and hospitals in that state to provide the Attorney General with 30 days’ notice prior to consummating any merger or affiliation-type transaction. The new law (P.A. 14-168) is noteworthy because the threshold for …
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Complying with Recent Changes to the Physician’s Notice of Privacy Practices
By Rose J. Willis A physician practice’s Notice of Privacy Practices (“NPP”) acts as the “roadmap” to the practice’s permitted uses and disclosures of their patients’ protected health information (“PHI”). September 23, 2013 was the deadline for revising NPPs to comply with the changes set forth in the 2013 HIPAA Omnibus Final Rule, meaning that …
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Ex Parte Communications between Treating Physician and Attorneys
By Keith C. Dennen Under HIPAA, physicians are permitted to disclose “protected health information” to their attorneys for purposes of their own healthcare operations. This allows physicians sued by patients for malpractice to provide their attorneys with the information needed to prepare and present a defense. Ordinarily, subpoenas or orders are a part of a …
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HIPAA Violation Results in $4.8 Million Settlement: An IT Perspective
By Jared A. Smith In today’s healthcare industry, information technology (“IT”) systems play an ever-expanding role in the success of a medical practice. Medical practitioners consistently juggle e-billing and electronic medical records software risk, HIPAA compliance issues, data security and data privacy requirements and meaningful use thresholds, all of which are typically addressed in IT …
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Recent Trends in HIPAA Liability
By Scott Roberts Since the passage of the 2013 HIPAA Omnibus Rule, there has been a substantial increase in HIPAA enforcement actions brought by the Department of Health and Human Services, including an increase in so-called “high-impact cases” where settlements can reach into the millions of dollars. In addition, while HIPAA does not provide for …