Legal and practical healthcare information.
ONC Final Rule Information blocking On May 1, 2020, the Federal Department of Health and Human Services (“HHS”), Office of the National Coordinator for Health Information Technology (“ONC”) released a Final Rule (the “ONC Final Rule”), which implements the information blocking provision of the 21st Century Cures Act, enacted in 2016. The information blocking provision …
Continue reading “HOW APPLICATION PROGRAMMING INTERFACES APPLY TO HEALTHCARE ENTITIES”
The United States Court of Appeals for the Ninth Circuit recently released an unpublished memorandum decision in the landmark mental parity case of Wit v. United Behavioral Health. In this decision, the Ninth Circuit reversed the district court’s order requiring UBH to reprocess more than 60,000 claims that had initially been denied for not meeting …
Continue reading “Updates to Wit v. United Behavioral Health”
On October 24, 2018, the Eliminating Kickbacks in Recovery Act (“EKRA”) was enacted. Broadly speaking, EKRA prohibits soliciting, receiving, paying, or offering “any remuneration (including any kickback, bribe, or rebate) directly or indirectly, overtly or covertly, in cash or in kind,” for referring or to induce a referral to a recovery home, clinical treatment facility, …
Continue reading “NEW EKRA INTERPRETATION PROVIDES SOME GUIDANCE IN ITS APPLICATION”
The Department of Justice recently released their Year in Review summary of activity by the Healthcare Fraud Unit, detailing enforcements efforts related to some of the more significant telehealth-related fraud claims in 2021. The DOJ’s litigation unit significantly expanded last year to support the Fraud Unit, resulting in material criminal prosecutions and sentences. Since 2019, …
Last month, we published an article summarizing new surprise billing laws that prohibit nonparticipating providers from balance billing patients when the patient’s insurance company pays less than the provider’s usual and customary charge. The Michigan law, known as the Surprise Medical Billing Law, has been in effect since last year. The Federal law, known as …
Continue reading “Court Strikes Down Portions of Federal Regulations Concerning No Surprises Act”
What are non-compete agreements? In the broadest sense, non-compete agreements prohibit an employee from accepting employment by a competitor of an employer for a certain time. They are treated differently than non-solicitation agreements and confidentiality agreements. While non-compete agreements may not solely prevent competition – the agreement cannot prohibit an employee from using general knowledge …
Continue reading “Physician Non-Compete Agreements: What You Should Know”
Erica Erman and Gregory Moore discussed some of the top developments in behavioral health during Dickinson Wright’s Health Law Summit. Below is a summary of what was discussed. Click here to view the full webinar. Table of Contents Development #1: New Trends in Parity Enforcement Recent Litigation, Including Wit v. United Behavioral Health Development #2: …
Since last year, certain providers (e.g., anesthesiologists, radiologists, surgeons, etc.) in Michigan have had to navigate Michigan’s Surprise Medical Billing Law (“Michigan Act”). Starting January 1, 2022, those same providers have also had to comply with the Federal No Surprises Act (“Federal Act”). Generally, both statutes prevent nonparticipating providers from balance billing patients when the …
Continue reading “SURPRISE! NEW LAWS IMPACT PATIENT BILLING”
Those serving in the health care industry are all too familiar with the Anti-Kickback Statute and the Stark Law – physician self-referral and fraud and abuse laws that prohibit financial payments or incentives for referring patients, specifically a Medicare or Medicaid patient. In December 2020, The Officer of Inspector General (OIG) Final Rule and the …
Continue reading “Anti-Kickback Statute and Stark Law Recent Updates”
Dickinson Wright Attorneys recently tackled some basic questions regarding private equity in health care during Dickinson Wright’s Health Law Summit. Below is a summary of what was discussed. Click here to view the full webinar. What is private equity? The term “private equity” is broad, referring to family offices, limited partnerships, and investment funds put …
Continue reading “Private Equity in Health Care: Answers to Industry Questions”