By Billee Lightvoet Ward Although the HIPAA Omnibus Rule (the “Rule”) went into effect nearly 18 months ago, the transition period for bringing business associate agreements into compliance with the Rule’s new requirements will end on September 23, 2014. Business associates were directly regulated and responsible for complying with the Rule as of September 23, …
FBI Warning to Health Care Sector Holds True
By Billee WardIn April of this year, the FBI issued a Private Industry Notification (PIN) to the health care industry warning of the “likely increase [in] cyber intrusions against health care systems.” In the same month, and into June of this year, a group of hackers originating from China were launching a cyber-attack on the …
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Tennessee Attorney General States that Physical Therapists Cannot Perform Trigger-Point Dry Needling
By Keith C. Dennen In an opinion released on June 19, 2014, the Office of the Tennessee Attorney General stated that Physical Therapists cannot lawfully perform Intramuscular Manual Therapy or Trigger-Point Dry Needling. Dry Needling therapy involves application of a fine, filiform needles to the neuromusculoskeletal system to restore movement, reduce pain, and address other …
Laboratory Payments to Physicians for Specimen Processing Present Substantial Risk of Fraud and Abuse
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. This post focuses on the first trend (Specimen Processing Arrangements); the second trend (Registry Payments) will be the subject of …
HHS Heat Initiative Continues Fraud Crackdown
By Scott F. Roberts A number of recent cases demonstrate Health and Human Services’ (“HHS”) Health Care Fraud Prevention and Enforcement Action Team’s (“HEAT”) continued success in cracking down on healthcare provider fraud. Since 2009, the federal government has recovered more than $12 billion dollars under the False Claims Act from cases involving health care …
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Peer Review is not always Privileged
By Keith C. Dennen Hospitals, ambulatory surgery centers and independent diagnostic centers cannot exist without physicians and other medical providers. In order to practice at those facilities, the medical professional often is required to be “admitted” to the medical staff of the facility. Although admission to the medical staff provides privileges, it often requires that …
Do Subsidized Health Care Plans Purchased Under the Affordable Care Act Trigger the Anti-Kickback Statute?
By Scott F. Roberts The advent of federally subsidized private pay health insurance under the Affordable Care Act has the potential to expand the application of the federal anti-kickback statute beyond just Medicare, Medicaid, and Tricare. The Affordable Care Act (sometimes referred to as “Obamacare”) currently allows individuals to purchase and receive private health insurance …
Legislation Permitting Healthcare Providers to Negotiate Jointly with Health Insurers Introduced in Congress
By James M. Burns Legislation was recently introduced by Representative John Conyers (D-Michigan) that would permit healthcare providers to negotiate jointly with health insurers concerning contract terms without running afoul of the antitrust laws. The bill, the “Quality Health Care Coalition Act of 2014,” (H.R. 4077), has been referred to the House Judiciary’s Subcommittee on …
The Academic Laboratory Exception
By Scott Roberts Part One: Determining Eligibility The federal Resource Conservation and Recovery Act, usually referred to as “RCRA”, governs the storage and disposal of hazardous waste, including hazardous medical waste. In addition to generally applicable regulations, RCRA provides a set of alternative rules, called the “Alternative Requirements for Hazardous Waste Determination and Accumulation of …
Windows XP Use May Violate HIPAA Starting April 8, 2014
By Rose Willis and Jared Smith If you use Windows XP on April 8, you will be easily susceptible to cyber-attacks and violations of the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”). Windows XP support is ending on April 8, 2014, when support and security updates will no longer be available. This means …
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