The Office for Civil Rights of the US Department of Health and Human Services, in conjunction with the Workgroup for Electronic Data Interchange (“WEDI”), has announced a series of four free webinars on compliance with the latest Omnibus HIPAA/HITECH final rule, which implements significant changes in the requirements imposed upon health care organizations, providers, and their… Continue Reading
In last week’s decision in Doe v. Guthrie Clinic, Ltd., the Second Circuit Court of Appeals certified to the New York Court of Appeals the issue of whether a medical corporation may be liable for the unauthorized disclosure of medical information, when the employee responsible for the breach was not a physician and was acting… Continue Reading
The US Department of Health and Human Services (“HHS”) Office for Civil Rights (“OCR”) released final rules on January 17, 2013 governing the privacy and security of protected health information under HIPAA and the HITECH Act. The new rules take effect March 26, 2013; compliance is expected by September 23, 2013. This post will focus on… Continue Reading
The Patient Protection and Affordable Care Act of 2010 (“PPACA” or “Obama Care”) requires, beginning in 2014, that employers with 50 or more full-time employees (“large employers”) offer “affordable” health insurance to its employees. Failure to do so will subject the employer to penalties. Future blog postings will address the coverage requirements and penalties under PPACA,… Continue Reading
On January 2, 2013, the US Department of Health and Human Services announced a $50,000 settlement with Hospice of North Idaho for a data breach involving the theft of a lost, unencrypted laptop computer containing the health information of 441 patients. This settlement is the first for a reported breach affecting fewer than 500 individuals. HHS Office of… Continue Reading
Just a reminder to New York State Medicaid providers that certifications under the NYS Social Services Law and the Federal Deficit Reduction Act are due no later than December 31. All New York State Medicaid providers who are required to have a compliance program under Social Services Law Section 363-d must certify that their compliance… Continue Reading
Earlier this week, the Department of Justice announced that it had recovered nearly $5 billion in settlements and judgments under the False Claims Act in fiscal year 2012. The $4.959 billion figure was a new record for a single year, eclipsing the previous one-year record by $1.7 billion. In breaking down the $5 billion in… Continue Reading
In late October the U.S. Attorney’s Office in the Southern District of New York announced the settlement of a False Claims Act case against Westchester Medical Center (“WMC”) for $7 million, for submitting false reimbursement claims to Medicaid from August 2001 through June 2010 involving outpatient behavioral health services. The settlement is to be paid… Continue Reading
The Health Information Technology for Economic and Clinical Health Act (the “HITECH”) Act of 2009 aims to have all hospitals and physicians use electronic health records (“EHRs”) for all persons in the United States by 2014. Federal and State financial incentives, electronic billing requirements, and the need for ever-increasing collaboration and sharing of information among… Continue Reading
The New York State Office of the Medicaid Inspector General (“OMIG”) recently finalized regulatory changes to New York State law which relate to the withholding of payments to Medicaid providers when there is a “credible allegation of fraud.” A credible allegation of fraud is defined as an “allegation that has indicia of reliability and has… Continue Reading
In United States ex rel. Feldman v. van Gorp , decided last week, the Second Circuit ruled on an issue of first impression concerning False Claims Act (“FCA”) damages in the context of a federal grant for medical research funding, and also addressed the FCA’s materiality standard. In Feldman, Cornell University and a psychiatry professor applied… Continue Reading
The US Department of Health and Human Services Office of Civil Rights (“OCR”) recently released its HIPAA audit protocol. Audits of HIPAA compliance were mandated by the 2009 Health Information Technology for Economic and Clinical Health (“HITECH”) Act, which amended many parts of HIPAA and included breach notification requirements. The OCR conducted a number of… Continue Reading
The New York State Office of the Medicaid Inspector General (“OMIG”) recently released its Compliance Program Guidance for General Hospitals. While the OMIG had previously released a Compliance Program Assessment Tool, the new Guidance document provides a far greater level of detail as to the expectations of a hospital’s compliance program. New York State law… Continue Reading
Several health care industry companies, including Medicis, ArthroCare and Amedisys, reported in their 2012 first quarter reports that they were under Department of Justice investigations and had received civil investigative demands from the government. Civil investigative demands, referred to as CIDs, are a particularly powerful pre-lawsuit administrative tool for federal investigations. Using CIDs, the government… Continue Reading
The 2010 Patient Protection and Affordable Care Act (“PPACA”) imposed an obligation upon Medicare providers, including physicians, hospitals, nursing homes and home health agencies, to report and return any overpayments they receive within 60 days of identification of the overpayment. Failure to do so could result in substantial penalties to the provider under the False… Continue Reading
Health care providers in New York that participate in Medicaid may be included in the latest cycle of the Centers for Medicare and Medicaid Services Payment Error Rate Measurement Program (“PERM”). PERM was developed in response to the Improper Payment Information Act, which requires that Federal agencies review programs that are prone to erroneous payments… Continue Reading
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