During the 2014 Legislative session, the Louisiana Legislature enacted the Louisiana Telehealth Access Act (the “Act”), La. R.S. 40:1300.401 et seq. In the Act, the Louisiana Legislature declared telehealth to be “extremely valuable” because it enhances access to care, promotes cost-effective delivery of care, and could improve health outcomes.[1] The Act, which became effective
U. S. Supreme Court Orders State Licensing Board to Cease and Desist Antitrust Activity
On February 25, 2015, the Supreme Court of the United States issued an opinion against the North Carolina Board of Dental Examiners (the “NC Board”) finding that the NC Board had violated federal antitrust law by issuing cease and desist letters to non-dental licensed persons who performed teeth whitening services. The case involved an administrative
OIG Issues Advisory Opinion on Preferred Hospital Network Proposal
The OIG issued Advisory Opinion 15-3 to address an arrangement proposed by a licensed offeror of Medicare Supplemental Health Insurance (“Medigap”) policies (the “Requestor”), in which the Requestor would indirectly contract with a preferred hospital organization (“PPO”) having contracts with a national network of hospitals (the “Network Hospitals”) for discounts on otherwise-applicable Medicare inpatient deductibles
OIG Would Not Sanction Arrangement Involving Payment to Excluded Provider for Pre-Exclusion Services
The latest OIG Advisory Opinion, issued February 9, 2015, addresses the issue of sharing federal health care program payments with an excluded practitioner. While federal statutes prohibit payment by any federal health care program, including Medicare or Medicaid, for items or services furnished by an excluded person or furnished at the medical direction or on
DHH Implements Recovery Audit Contractor Program
The Louisiana Department of Health and Hospitals (“DHH”) adopted provisions to establish the Recovery Audit Contractor (“RAC”) Program, effective November 20, 2014, as required by the Affordable Care Act. The new RAC program provides yet another mechanism by which DHH, through its contractors, can conduct post-payment audits of claims submitted by providers enrolled in Medicaid.
DHH Proposes Rule on Prohibition of Provider Steering of Medicaid Recipients
On September 20, 2014, the Department of Health and Hospitals (“DHH”) published its notice of intent to promulgate a rule to continue the provisions of a March 20, 2014 Emergency Rule regarding the prohibition on provider steering of Medicaid recipients to select a particular health plan. DHH had previously promulgated an Emergency Rule on this
DHH Implements New Adverse Actions Web Search for Excluded Individuals and Entities
To participate in the Louisiana Medicaid Program, providers have been required to ensure that their current and potential employees, contractors and other agents and affiliates were not excluded from participation in the Medicare or Medicaid Programs. Providers have been instructed to check the Department of Health and Human Services’ Office of Inspector General’s website for
Prescription Monitoring Program Now Accessible By Delegates
The Louisiana Board of Pharmacy has revised the rules on access to patient information maintained by the Prescription Monitoring Program (“PMP”). Historically, only persons authorized to prescribe or dispense controlled substances or drugs of concerns could access the PMP. The Board recently revised the PMP rules to now allow a “delegate” of the prescriber or
CMS and ONC Issue Final Rule Modifying Meaningful Use Requirements
On August 29, 2014, the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) issued a final rule modifying the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs. While CMS is responsible for managing the EHR incentive programs and meaningful use, ONC is responsible
ONC Report on Surge in Use of Electronic Health Records (“EHR”)
Two recent studies published by the office of the National Coordinator for Health Information Technology (the “ONC”) suggest that the use of electronic health records among physicians and hospitals has greatly increased. The study is based on information collected in calendar year 2013.
According to ONC, approximately 78% of office-based physicians have adopted some form