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
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
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
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 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
By Banee Pachuca and Darby C. Allen on Posted in Uncategorized
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
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
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
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
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
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
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
Editor’s Note: This post is a joint submission with BakerHostetler’s Data Privacy Monitor blog. On January 25, 2013, the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) published the long-awaited HIPAA Omnibus Final Rule (Final Rule), which includes the most sweeping changes to HIPAA since the Privacy and Security Rules were released. … Continue Reading