Tag Archives: providers

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

ONC Contracting Guide Aims to Restore Balanced Bargaining Between Providers and EHR Vendors

The HHS Office of the National Coordinator for Health Information Technology (ONC) recently published a contracting Guide to assist healthcare providers when entering into electronic health record (EHR) contracts with EHR vendors. Issued in response to provider complaints that EHR contracts often contain hidden fees and restrictions that prevent sharing of patient health records with other providers, … 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

Assault of Home Health Worker by a Patient’s Father Prompts OSHA Violation

A provider of pediatric home health, Epic Health Services, was recently fined $98,000 by the Occupational Safety and Health Administration (OSHA) in connection with the sexual assault of a home health employee by a patient’s father. Allegations include that the father had regularly attempted to grope the employee and made inappropriate comments about her buttocks … Continue Reading

Deeper Dive: Integrating Physician Practices into a Health System’s HIPAA Privacy and Security Program

The health system needs to understand its IT capabilities and operating competencies and develop the required infrastructure to support clinical integration of the physician practices The healthcare industry shift to a value-based business model is resulting in greater alignment between hospitals and physicians to provide quality, outcomes driven care in order to receive payment for … Continue Reading

Debt Collector for Affiliated Physician Group Can Rely on Patient Contact Consent Obtained by Hospital

Careful drafting of consent and information release provisions can ensure that providers and affiliated physicians and their debt collectors can contact patient cell phones using automatic telephone dialing systems or artificial or prerecorded voices. The Sixth Circuit recently held that a hospital-based anesthesia group’s debt collector did not violate the Telephone Consumer Protection Act (TCPA) when it … Continue Reading

Don’t Get Phished! Hackers Pose as CEOs to Steal Tax Information from HR and Payroll Professionals at Healthcare Organizations

Every tax season is plagued with scams to defraud individuals and companies for money from tax returns. However, this year has started off with a bang and this means that the healthcare industry has another reason to worry. On March 1, 2016, the IRS issued an alert warning “payroll and human resources professionals to beware of an … Continue Reading

Protecting Patient Data From Hacker Ransom Demands

Forty bitcoins later (approximately $17,000), Hollywood Presbyterian Hospital can now access its electronic medical health records and return to treating its patients as scheduled. But as hackers develop new tools to access information, an increasing number of providers will be targeted and ransom demands will escalate, putting hospitals and patients at risk. Focusing on technical … Continue Reading

Providers Oppose CMS Proposal Targeting Prescription Drug Abuse by Part D Enrollees

Providers have voiced opposition to a proposal aimed at targeting Medicare Part D enrollees with “potential opioid or acetaminophen overutilization issues that indicate the need to implement appropriate controls on these drugs for the identified beneficiaries.” Under a recently proposed rule on revised discharge planning requirements, CMS solicited comments on whether providers should be required to consult … Continue Reading

The Deeper Dive: Guarding Against Unrealistic Goals and Organizational Pressures That Can Lead to Compliance Failure

When misconduct occurs within an organization, it is often reported and interpreted as an anecdote involving a few rogue employees who are quickly identified and appropriately disciplined. Misconduct derives, at least in part, from the organizational environment, and studies suggest that pressure from management and the board of directors to meet unrealistic business objectives and … Continue Reading

Meaningful Use Stage 3 Final Rule Reduces Provider Burdens

CMS and the Office of the National Coordinator for Health Information (ONC) recently released the 752-page final rule for Meaningful Use Stages 2 (MU2) and 3 (MU3). The final rule provides a flexible timeline for providers and reduces the number of objectives and accompanying clinical quality measures required for reporting. The rule further provides that: … Continue Reading

D.C. District Court Deals Blow to HHS 340B Program Interpretive Rule

Court says Congress has the power to make the change that HHS attempted with its Interpretive Rule, and thus it should be left to the legislative branch. A lawsuit challenging the Interpretive Rule, filed by the Pharmaceutical Research and Manufacturers of America (PhRMA) in October 2014, was recently vacated in favor of PhRMA by the … Continue Reading

House Passes Bill to Help Prevent Prescription Drug Abuse

On September 8, 2015, the House of Representatives passed a bill intended to combat prescription drug abuse through the reauthorization of a program that provides federal grants to states for prescription drug monitoring programs (PDMP). The National All Schedule Prescription Electronic Reporting (NASPER) Reauthorization Act, (H.R. 1725), authored by Rep. Edward Whitfield (R-Ky.) and Rep. … Continue Reading

NLRB Blows Up Staffing Agency Model: Rewrites Joint-Employer Test

Boom! In a 3-2 decision, the National Labor Relations Board (NLRB) spontaneously redefined joint employment in a way that threatens to turn almost every healthcare provider that works with a management company or staffing agency into a joint employer for collective bargaining purposes. Read more on BakerHostetler’s Employment Law Spotlight blog >>… Continue Reading

340B Guidance: Eight Key Points Covered Entities Should Consider

On August 27, 2015, the Health Resources and Services Administration (HRSA), an agency of the U.S. Department of Health and Human Services (HHS), released the 340B Drug Pricing Program Omnibus Guidance (Guidance). Referred to as “proposed” guidance by HRSA, the Guidance is intended to clarify a multitude of issues for the thousands of registered covered … Continue Reading

New Jersey Tax Court Eliminates Non-Profit Hospital’s Property Tax Exemption

On June 25, 2015, a New Jersey Tax Court issued a significant opinion in the case of AHS Hospital Corp. d/b/a Morristown Memorial Hospital v. Town of Morristown, upholding the Town of Morristown’s denial of Morristown Memorial Hospital’s (the Hospital) property tax exemption for tax years 2006 through 2008 with only a few minor exceptions. … Continue Reading

Proposed 340B Rule Would Impose Penalties for Overcharging, Plus Other Charges

A recently-released proposed rule would impose civil monetary penalties on drug manufacturers that intentionally overcharge healthcare providers for medications purchased under the 340B Discount Drug Program. The proposed rule, if adopted, could open the door to significant financial penalties for manufacturers, even if it is the manufacturer’s wholesaler or other business partner that overcharges the … Continue Reading

Compounding Pharmacies Protected by Medical Liability Act

In a court decision holding that a compounding pharmacy is entitled to certain protections against medical malpractice claims, the Supreme Court of Texas established a precedent that may well prove valuable to pharmacists facing lawsuits stemming from compounded drugs. The court ruled that claims brought by a patient who allegedly suffered serious injuries as a … Continue Reading

OMB Reviewing HRSA Proposed Rule For Civil Monetary Penalties And Ceiling Price Regulations For 340B Drug Discount Program

The agency that oversees the 340B Drug Discount Program (340B program) is seeking review by the White House Office of Management and Budget (OMB) of a proposed rule that would use civil monetary penalties to enforce ceiling price regulations. The Rule, proposed by the Health Resources and Services Administration (HRSA), rule seeks to enforce the … Continue Reading

Volunteer Directors and Officers Liable to Facility Creditors

The Third Circuit Court of Appeals recently upheld a trial court’s jury verdict finding the individual board members and officers of a non-profit healthcare facility personally liable to the facility’s creditors. The board members had a false sense of security based upon the incorrect notion that board members of non-profit organizations, most of whom serve … Continue Reading

The ACA Five Years Later: A Good Investment or Risky Business? We Dare Not Opine!

The enactment of the Patient Protection and Affordable Care Act (ACA), signed into law on March 23, 2010, represents a significant legislative milestone in healthcare reform and a continuing communications challenge for providers. As we approach the mid-point of the law’s 10-year implementation trek, a look back at the healthcare investor market shows that despite … Continue Reading

CMS Releases New Proposal to Improve Accountable Care Organizations

The Centers for Medicare and Medicaid Services (CMS) recently released a proposed rule aimed at revitalizing accountable care organizations (ACOs) under the Medicare Shared Savings Program (MSSP). Given the low level of ACOs receiving shared savings payments in their first year, CMS is making several proposals to adjust participants’ risk levels to encourage continued participation. … Continue Reading

HRSA Withdraws Proposed “Mega Rule” for 340B Drug Pricing Program

The Health Resources and Services Administration (HRSA), an agency of the U.S. Department of Health and Human Services (HHS), has withdrawn a proposed omnibus rule, referred to as the “mega rule,” for the 340B Drug Pricing Program. The mega rule was expected to cover contract pharmacy compliance and eligibility criteria for patients, hospitals and off-campus … Continue Reading
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