On November 20, 2020, the Centers for Medicare & Medicaid Services (“CMS”) and the Office of the Inspector General (“OIG”) finalized the rules modifying the safe harbors under the Anti-Kickback Statute and exceptions under the Stark Law. These new rules take effect as of January 19, 2021. Due to their complexity, this article will focus …
How Employers Can Handle Their Biggest Threat to Data Privacy, Their Employees
Given the ever-expanding landscape of privacy laws and regulations, employers are becoming increasingly aware that they are responsible for data breaches caused by their employees. When looking to formally put obligations upon employees to modify employee conduct, employers tend to start with policy, such as in an employee handbook to allow a means of internal …
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May Highlights: National Healthcare Law News
-Earlier this month, on May 7, 2018, the Senate passed bipartisan S.B. 1732, entitled the “Improving Access to Behavioral Health Information Technology Act.” The bill, which is currently in the House of Representatives, aims to provide “incentive payments to behavioral health providers for the adoption and use of certified electronic health record technology…to improve the …
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Costs Down; Quality Up
How can providers increase quality of care while reducing cost to patients? The answer is through innovation, creativity, increased patient responsibility, partnership, and real-time flow of information. Here are just a few ideas to consider in reaching this overarching goal. While none of the ideas articulated below are novel or groundbreaking on their own, they …
Is Your Physician Organization Complying with Antitrust Law?
It is not uncommon for a physician organization to act as an intermediary between its physician participants and third-party payers to facilitate the negotiation and acceptance of reimbursement rates and other payer contract terms. However, when facilitation becomes negotiation and a PO accepts contracts with third-party payers on behalf of physician participants, also known as …
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Prescription for Fraud: Government Enforcement Activities in Compounding Pharmacies
On October 18, 2017, a Mississippi physician was charged with health care fraud for writing prescriptions for medically unnecessary compounded medications. This is the latest – though certainly not the last – example of the Department of Justice’s efforts to combat fraud within the TRICARE program. From California to Florida, federal prosecutors have charged physicians, …
Blessings in Disguise: Hidden Opportunities in Health Care Bankruptcies
In 2016 alone, 21 hospitals were closed across the United States because of unsustainable financial performance1, and the trend has continued with 7 additional hospitals and 18 other hospital departments closing in just the first half of 20172. Financial challenges facing many entities in the health care industry are not limited to hospitals, or even …
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