Legal and practical healthcare information.
Russell Kolsrud and Gregory Moore recently authored the article, “Why you need to integrate behavioral health into your primary care practice,” for Physicians Practice. The article discusses the continuous debate regarding various health insurance reform addressed in the ACA and the effects it has had on the behavioral health industry. Kolsrud and Moore also discuss …
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Erica A. Erman recently authored the article, “The importance of putting patient care above profits,” for Physicians Practice. The article discusses the case Wit v. United Behavioral Health and highlights eight principles that the court found to be generally accepted standards of care among behavioral professionals. “The importance of accessible quality behavioral health services is …
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The American Medical Association CPT Editorial Panel released eight standardized and permanent codes for billing applied behavioral analytics (ABA) therapy services that became effective January 1, 2019. For the first time, adaptive behavior services are standardized for the purposes of billing and payment for those services by CMS and other third-party payors. This should be …
Individuals who use healthcare apps such as fitness trackers, weight loss, wellness, exercise, etc., BEWARE! A couple of recent developments have highlighted the fact that most apps are not subject to HIPAA, which means that with broadly-worded privacy policy these healthcare apps can and do readily share healthcare and other data collected by the apps …
With medical marijuana legal in an ever-growing number of states, many businesses in the cannabis industry, particularly dispensaries, continue to wrestle with the question of whether they are subject to the Health Insurance and Portability and Accountability Act’s (HIPAA) Privacy and Security Rule requirements. The bad news is that the answer is, it depends. The …
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Purpose and Practicality The HIPAA Security Rule[1] was designed to protect the confidentiality, integrity, and availability of a patient’s protected health information (PHI) while allowing flexibility for each covered entity based on their size, complexity, technological capabilities, cost constraints, and the likelihood of potential risks to the electronic PHI (ePHI) they house. To make the …
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In its latest case addressing retiree health benefits, the Sixth Circuit Court of Appeals has held that a collective bargaining agreement’s general durational clause controls when retiree healthcare benefits end. Zino v. Whirlpool Corp., 2019 BL 50961, 6th Cir. (2019). This is a new data point indicating that the Sixth Circuit has moved away from …
Perhaps one thing we can agree on in discussing the healthcare industry: it is in a state of distress stemming from the challenges created by an ever-increasing regulatory burden, changes in reimbursement rates, uncertainty with the Affordable Care Act, mounting tort and employment litigation. The recent rampant growth of urgent care centers and retail clinics …
Continue reading “Blessings in Disguise: Hidden Opportunities in Healthcare Bankruptcies”
Telemedicine is a relatively new concept that allows healthcare providers to treat patients via the Internet through varying technology platforms, such as FaceTime or Skype. While the practice initially started as a means for healthcare providers to treat patients in rural or remote areas who were far away from local health facilities or in areas …
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Earlier this month, on March 5, 2019, the U.S. District Court in the Northern District of California filed a 106-page Findings of Fact and Conclusions of Law in the class action Wit v. United Behavioral Health (“UBH”). Here are the highlights: Under ERISA, Plaintiffs asserted two claims against UBH based on UBH’s Level of Care …
Continue reading “Court Rules UBH Coverage Guidelines a Monumental Fixer-Upper”