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
Obama Care Employer Mandates: Who Must Comply?
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
First HHS Settlement for Small HIPAA Breach
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.
Compliance Certifications Due By 12/31
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
Department of Justice Announces Record-Setting Year of False Claims Act Recoveries
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
Hospital Settles False Claims Act Case For $7 Million
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
Electronic Health Records Come Under OIG Scrutiny
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
OMIG to Withhold Payments for “Credible Allegations of Fraud”
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
The False Claims Act and Federal Grants
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
Feds Release HIPAA Audit Protocol
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