Tag Archives: HHS

Capitol Hill Healthcare Update

Senate Readies for Key Procedural Vote on Healthcare Bill – Maybe Senate Republicans face a key procedural vote this week that would allow for debate of their healthcare legislation, but significant uncertainty remains about whether GOP senators can meet that procedural hurdle, what the underlying healthcare bill would be and how an impending White House … Continue Reading

Bundled Payments Out in the Cold? Another Delay for Mandatory Bundled Payment Models

This most recent delay raises questions concerning how the Trump administration intends to implement value-based payment in the Medicare program. The Centers for Medicare and Medicaid Services (CMS) has delayed again the implementation date of its final rule mandating hospital participation in two new cardiac episode-based payment models (EPMs) and an expansion of the Comprehensive … Continue Reading

Destination Medicine: Not Just for the Rich and Famous

OIG okays providing modest hotel and meal accommodations for rural and financially needy patients. The U.S. Department of Health and Human Services Office of Inspector General (OIG) recently issued an advisory opinion interpreting the finalized rules related to the beneficiary inducement civil monetary penalties (CMP) law. In a previous blog post, we discussed the OIG … Continue Reading

Capitol Hill Healthcare Update

AHCA Autopsy: What Happened, What’s Next? House Speaker Paul Ryan’s decision to cancel Friday’s vote on the American Health Care Act triggered post-mortem jockeying among vying GOP factions struggling to come to grips with how the party failed to repeal a law it has singularly campaigned against for the last seven years. Republicans’ inability to … Continue Reading

Capitol Hill Healthcare Update

At HHS, Price will lead Trump’s efforts on ACA repeal Three weeks into President Trump’s administration, the Senate on Friday narrowly approved Tom Price as Secretary of the U.S. Department of Health and Human Services (HHS), elevating the former orthopedic surgeon as Trump’s point person on repealing and replacing the Affordable Care Act (ACA). Price … Continue Reading

Capitol Hill Healthcare Update

GOP leaders delay ACA action amid “repeal,” “repair” debate House Speaker Paul Ryan last week set a deadline of the end of March for repealing most of the Affordable Care Act (ACA), as other Republican leaders and conservative rank-and-file lawmakers advocated competing policy alternatives for what would follow the health law. Congressional Republicans had hoped … Continue Reading

Capitol Hill Healthcare Update

At GOP retreat, consensus on healthcare elusive House and Senate Republicans emerged from a policy retreat last week in Philadelphia with no agreement on next steps in their plan to repeal and replace the Affordable Care Act (ACA). Most congressional leaders, including House Energy and Commerce Committee Chairman Greg Walden (R-Ore.), urged rank-and-file lawmakers to … Continue Reading

Federal Court Enjoins Part of ACA Final Non-Discrimination Rule

On December 31, 2016, the U.S. District Court for the Northern District of Texas issued a nationwide injunction in Franciscan Alliance, Inc. v. Burwell, N.D. Tex., No. 16-cv-108, holding that portions of the final rule issued by the HHS Office for Civil Rights (OCR), which sought to operationalize Section 1557 of the Affordable Care Act (ACA), … Continue Reading

Capitol Hill Healthcare Update

Congress sets up bill to repeal ACA The House on Friday gave final congressional approval to a budget blueprint that authorizes separate filibuster-proof legislation Republicans will use next month to repeal much of the Affordable Care Act (ACA). Republican-led committees in the House and Senate now will begin drafting the so-called reconciliation legislation that will … Continue Reading

Capitol Hill Healthcare Update

A growing number of moderate and conservative Republicans in Congress are voicing concerns about the party’s strategy to repeal the Affordable Care Act (Act) in February but then wait months – and possibly even into 2018 – before developing a replacement plan. Republicans, including President-elect Trump, have said the party’s No. 1 priority is repealing … Continue Reading

Capitol Hill Healthcare Update

New Congress targets ACA repeal Republican congressional leaders overseeing the new 115th Congress will trigger a legislative process this week which will likely culminate in February with the repeal of most of the Affordable Care Act (ACA). The Senate will vote on a budget framework that will authorize separate legislation known as budget reconciliation. That … Continue Reading

Capitol Hill Healthcare Update

House Oks “Cures,” Senate Votes This Week The Senate this week is likely to give final congressional approval to legislation that adds billions of dollars for biomedical research and aims to speed the discovery and development of new drugs and medical devices. The “21st Century Cures” legislation won House approval last week 392-26. Although several … Continue Reading

OCR Issues Alerts Regarding Phishing Email Disguised as Official OCR Audit Communication

The OCR issued another alert relating to the phishing email campaign and has shared that the phishing email originates from the email address OSOCRAudit@hhs-gov.us and directs individuals to a URL at http://www.hhs-gov.us. This is a subtle difference from the official email address for OCR’s HIPAA audit program, OSOCRAudit@hhs.gov. Covered entities and business associates should alert … Continue Reading

The Deeper Dive: Section 1557 Attempts to Return the “Care” to “Healthcare”

The U.S. Department of Health and Human Services (HHS) moved to the forefront of anti-discrimination measures when it released a final rule, titled “Nondiscrimination in Health Programs and Activities” (Final Rule), implementing Section 1557 of the Affordable Care Act (ACA), which prohibits discrimination on the grounds of race, color, national origin, sex, age or disability in … Continue Reading

Summer Fraud and Abuse Roundup

Now that the kids are back in school and summer vacations are in the rearview mirror, it’s time to catch up on recent fraud and abuse developments. The federal government was busy this summer negotiating a pair of settlements under the Stark Law and anti-kickback statute, drafting changes to the Self-Referral Disclosure Protocol (SRDP), and … Continue Reading

Medicare Advantage Plan Arbitration Clauses Preempted by Medicare Appeals Process

The Arizona Supreme Court, in an interesting case involving a Medicare-related coverage dispute between a Medicare Advantage plan administrator, United Behavioral Health (UBH), and two inpatient psychiatric care providers, held that the Medicare administrative appeals process preempts the arbitration language contained in the UBH provider agreements. The court also remanded the case back to the … Continue Reading

HHS Reopens Comment Period for Proposed Rule on 340B Drug Program

The U.S. Department of Health and Human Services (HHS) is reopening the comment period for the proposed rule titled “340B Drug Pricing Program Ceiling Price and Manufacturer Civil Monetary Penalties Regulation.” HHS released the proposed rule on June 17, 2015, and the original comment period ended August 17, 2015. The 340B Drug Pricing Program requires drug manufacturers … Continue Reading

HHS Removes Barriers to Reporting Federal Mental Health Prohibitor Status for Gun Background Checks

On January 6, 2016, the U.S. Department of Health and Human Services (HHS) released amodification to the Health Insurance Portability and Accountability Act (HIPAA) removing barriers to reporting federal mental health prohibitor status for gun background check purposes. The new section, 45 C.F.R. § 164.512(k)(7), allows a covered entity to use or disclose protected health information … Continue Reading

OCR Continues Waving Its HIPAA Enforcement Flag: Don’t Forget About Medical Devices

The day before Thanksgiving, the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) announced the largest resolution agreement of 2015, against Lahey Hospital and Medical Center (Lahey). The incident giving rise to the $850,000 settlement was apparently an isolated theft involving 599 patients with electronic protected health information (ePHI) on … Continue Reading

OCR Updates Breach Report Web Portal — Changes Could Impact Annual Breach Reports

The U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) recently launched an updated version of the portal covered entities must use to notify OCR regarding a breach of unsecured protected health information (PHI) under 45 C.F.R. § 164.408, and the changes could impact covered entities planning to submit their 2014 … Continue Reading

Managing Your Health Information Risks Should Not Begin After a Breach Is Reported

Editor’s Note: We recently launched a graphic illustrating our Cyber Risk Mitigation Services. Our attorneys have written about specific examples of those services. Healthcare is plagued by a high frequency of reported breaches. Although they are often caused by employees making mistakes, such as misdirecting a fax or losing a thumb drive, we are seeing more and … Continue Reading
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