Legal and practical healthcare information.
It is no secret that protected health information (or “PHI”) is more and more at risk for cybersecurity attacks. In 2022 (the most recent year this statistic is available), the Department for Health and Human Services Office for Civil Rights (“OCR”) received over 30,000 new complaints alleging violations of HIPAA and, in addition to other …
Continue reading “How Did They Get My Protected Health Information?”
Prior to the COVID-19 public health emergency (“PHE”), the federal Ryan Haight Act allowed a provider to prescribe controlled substance medications to a patient only after conducting an in-person evaluation of that patient (with limited exceptions). At the beginning of the PHE, the Drug Enforcement Agency (“DEA”) granted temporary exceptions to the in-person requirement and …
Continue reading “Telehealth Update: Controlled Substances & E/M Claims”
The Federal False Claims Act (“FCA”) imposes civil liability for presenting a false claim to the government for payment. The Federal Anti-Kickback Statue (“AKS”) prohibits medical providers from making referrals in return for “remuneration.” In a recent decision by the Sixth Court of Appeals, the Court found that a hospital’s decision not to hire an …
Continue reading “Sixth Circuit Defines False Claims Standards”
The current Public Health Emergency expiration deadline is this month. However, the Secretary of the Health and Human Services indicated he would provide a 60-day notice before ending the PHE in order to minimize disruptions and potential loss of government and private insurance coverage. That notice has not yet occurred. Therefore, we expect another 90 …
Continue reading “Telehealth Update: Telehealth Waivers Post-PHE and Fraud and Abuse”
The Department of Health and Human Services (“HHS”) recently announced guidelines for the application of the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) to audio-only telehealth encounters following the end of the declaration of the COVID-19 public health emergency (“PHE”). As reported here at the beginning of the Covid-19 pandemic, the HHS Office …
Continue reading “Post-Pandemic HIPAA Guidelines for Audio-Only Telehealth”
As previously reported here, courts are known to “blue pencil” terms of non-compete provisions in employment agreements that do not appear to further legitimate business interests. Earlier this year, an Ohio appellate court affirmed the lower court’s modification of the scope and duration of a challenged non-compete provision found to be partially unreasonable. In Metrohealth …
Continue reading “Recent Guidance on Enforceability of Physician Non-Competes”
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, …
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”
As anticipated, the federal government has been monitoring the potential for fraud and abuse involving telehealth. Providers, lab owners, and medical equipment companies have been recent targets of investigations. The government’s attention has focused on claims related to durable medical equipment and lab testing. In September, the Department of Justice announced a nationwide enforcement action …
New and modified safe harbors to the Stark Law and Anti-Kickback statue allow healthcare providers and entities more flexibility to create and expand telehealth platforms in compliant fashion. 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 …