Ransomware is here to stay. According to a recent United States Government interagency report, on average, there have been approximately 4,000 daily ransomware attacks since early 2016, which is a 300 percent increase from the approximately 1,000 daily ransomware attacks reported in 2015.[1] A significant percentage of those affected by ransomware have been healthcare
Failure to Have a HIPAA Business Associate Agreement Results in $750,000 Fine
On April 14, 2016, the U.S. Department of Health and Human Services (HHS), Office for Civil Rights (OCR), entered into a $750,000 settlement with a North Carolina orthopaedic clinic arising from the clinic’s disclosure of x-ray films and related protected health information of 17,300 patients to an entity that was engaged by the clinic to
CMS Issues Final Rule for Face-to-Face Requirements for Home Health Services Covered by Medicaid
The Department of Health and Human Services, Centers for Medicare and Medicaid (“CMS”) issued a final rule on February 2, 2016 regarding the requirements for a face-to-face encounter for patients receiving home health services payable by Medicaid. In order to ensure that states and providers appropriately implement the provisions in the final rule, CMS revised
CMS Issues Final Rule for Reporting and Returning Overpayments
On February 12, 2016, the Department of Health and Human Services, Centers for Medicare and Medicaid Services (“CMS”) promulgated the final rule on the requirement that providers and suppliers receiving funds under the Medicare program report and return overpayments by the later of sixty (60) days after the date on which the overpayment was identified
Attention Louisiana Physicians: State Board of Medical Examiners Issues Final Rules on the Complaint and Investigation Process
On December 20, 2015, the Louisiana State Board of Medical Examiners’ (“LSBME”) published in the Louisiana Register the final rules for processing complaints against physicians and investigations regarding the practice of medicine. The new rules are contained in Chapter 97 of LAC 46:XLV and are a result of Act 441 of the 2015 Legislative session,
Happy New Year! ACA Reporting Deadlines Extended
On December 28, 2015, the IRS announced an automatic extension of the Affordable Care Act reporting deadlines for distributing and/or filing the 1094-B/1095-B and 1094-C/1095-C forms. This relief only applies for the 2015 calendar year.
For employers who were considered applicable large employer members (“ALE members”) in 2015, the new deadline for furnishing your full-time
United States Supreme Court to Address the Theory of “Implied Certification” Under the False Claims Act
On December 4, 2015, the United States Supreme Court granted a Petition for a Writ of Certiorari in Universal Health Services, Inc. v. United States and Commonwealth of Massachusetts ex rel. Julio Escobar and Carmen Correa. The Petition was filed by Universal Health Services, Inc. (“UHS”) challenging the United States Court of Appeals for the
The HEAT is Turned Up on Medicare Fraud
The U.S. Department of Justice (DOJ) and U.S. Department of Health and Human Services (HHS) announced on June 18, 2015, that the efforts of the Health Care Fraud Prevention & Enforcement Action Team (HEAT), a joint initiative between the DOJ and HHS to prevent and deter Medicare fraud, resulted in a nationwide Medicare Fraud Strike
OIG Issues New Fraud Alert on Physician Compensation Arrangements Such As Medical Director Agreements
On June 9, 2015, the OIG issued a new Fraud Alert, cautioning physicians who enter into compensation arrangements such as medical directorships to ensure that the arrangements reflect fair market value for bona fide services that the physicians actually provide. The OIG reiterated that a compensation arrangement could violate the Anti-kickback Statute if even one
Louisiana Employers Beware: Your Reimbursement Plan May Violate Affordable Care Act Market Reforms
Many employers in the past have offered employees cash to reimburse the purchase of an individual policy from a private insurance carrier or on the Marketplace (aka the Exchange) or for other substantiated medical expenses in place of employer sponsored group health coverage. However, the federal government has recently taken the position that such an