Articles and Blogs

The past several years have seen a trend of attorneys now taking on the role of relator as well as counsel. This raises a new question: how are relators who act as counsel to be rewarded? By the relator’s share? By attorneys’ fees? By both? That question was answered recently by the Illinois Supreme Court, interpreting... READ MORE

The Department of Health and Human Services Office for Civil Rights (“OCR”) fined three separate hospitals a cumulative total of $999,000 to settle potential violations of HIPAA arising from allowing film crews on premises to film a reality television show without first obtaining patient authorizations. The OCR Resolution Agreement can be found here. Generally, a... READ MORE

On September 5, 2018, the Michigan Legislature voted to approve the Earned Sick Time Act (the “Act”), the Midwest’s first statewide paid sick and safe time law.[1] The Act requires employers to provide employees with earned sick time, up to 72 hours per year, for certain covered reasons, such as mental or physical illness... READ MORE

Hospitals Release Voluntary 340B Principles as Alternative to Legislation The battle over 340B continued this week as hospital groups announced a new voluntary 340B reporting program as an alternative to congressional legislation that would further regulate the program. Under the American Hospital Association-led initiative, hospitals would commit to publicly disclosing their 340B savings annually.... READ MORE

NATIONAL How ASC facilities turn their smaller operations into safer operations Private equity pushes into healthcare Walmart wants to bring its ‘everyday low prices’ to health care Only 18% of physicians say value-based payments will improve care, survey finds Half Of U.S. Doctors Have Pay Tied To ‘Value-Based Metrics’ HHS launches ASC safety database... READ MORE

On August 7, 2018, the Centers for Medicare & Medicaid Services (“CMS”) issued a Memorandum (“Memorandum”) announcing a policy change to allow Medicare Advantage (“MA”) plans to implement step therapy programs for physician-administered and other Part B drugs. Step therapy is a type of prior authorization for drugs in which a health plan requires... READ MORE

In the era of value-based care, health care providers and manufacturers are increasingly examining risk sharing opportunities in the treatment of patients. On September 17, the Department of Health and Human Services Office of Inspector General (“OIG”) published Advisory Opinion 18-10 whereby it approved a proposed risk sharing initiative with defined guardrails. Advisory Opinion... READ MORE

As Hurricane Florence inaugurates the U.S. hurricane season with fierce winds and torrential rains, health care providers are preparing to care for patients under demanding and dangerous conditions. Effective communication is always challenging and critically important when natural disasters like hurricanes strike. The Health Insurance Portability and Accountability Act (“HIPAA”) Privacy Rule (the “Privacy... READ MORE

Nearly a decade has passed since the U.S. Congress enacted the Patient Protection and Affordable Care Act (the “ACA”). Since March 2010, we have seen federal court rulings on numerous challenges to the ACA itself and the executive branch’s efforts to enforce the ACA. One such challenge resulted on September 7, 2018 in the... READ MORE

On August 27, 2018, the Department of Health and Human Services (“HHS”) Office of Inspector General (“OIG”) published a Request for Information (“RFI”) regarding the Anti-Kickback Statute (“AKS”) and Civil Monetary Penalties Law (“CMP”). The RFI, published as a result of HHS’s desire to transition the current health care system to one that pays... READ MORE