Articles and Blogs

On May 12, 2017, a massive cyber attack affecting health care organizations across the world prompted the United States Department of Health and Human Services (“HHS”) to issue a warning to U.S. health care organizations. The attack apparently first began in England, causing information systems at health care organizations throughout the country to become infected... READ MORE

On May 10th and May 12th, respectively, CGS Administrators, LLC (“CGS”) and Wisconsin Physician Services, Inc. (“WPS”) issued clarifications related to the MACs’ Local Coverage Determinations (“LCDs”) for polysomnography and other sleep studies. Click here for background on these LCDs. Due to efforts by state hospital associations, the MACs recognized that some hospitals relied... READ MORE

Title VII of the of the 21st Century Cures Act (the “Act”) underscores the importance of evidence-based programs and practices for diagnosing, preventing, treating and recovering from mental and substance use disorders. Title VII amends the Public Health Service Act to ensure that such programs reflect the increased knowledge obtained through the progress in... READ MORE

If HIPAA covered entities thought the increased rate of enforcement actions at the beginning of 2017 by the Department of Health and Human Services (“HHS”) Office for Civil Rights (“OCR”) was an anomaly, a flurry of settlement announcements by OCR in April indicate the trend may continue. The three recent enforcement actions discussed below... READ MORE

In a decision released May 4, 2017, the Wisconsin Supreme Court held that personal injury attorneys obtaining medical records on behalf of their clients are exempt from statutory certification and retrieval fees (Moya v. Healthport Technologies, LLC, 2017 WI 45, ¶ 2.). The plaintiff was involved in a motor vehicle accident and retained counsel... READ MORE

Wisconsin Physician Services, Inc. (“WPS”), the Medicare Administrative Contractor (“MAC”) for J5 (Iowa, Kansas, Missouri and Nebraska) and J8 (Indiana and Michigan) recently issued a local coverage determination (“LCD”), LCD (L36839), revising accreditation requirements for polysomnography and other sleep studies. Historically, the LCD stated that a hospital could use The Joint Commission (“TJC”) accreditation... READ MORE

In the March 14, 2017 Federal Register, the Food and Drug Administration (“FDA”) announced that it is considering establishing a new Office of Patient Affairs (“Office”). This consideration results from FDA’s intention to “enhance future patient engagement by providing a more transparent, accessible, and robust experience for patient communities.”1 The Federal Register notice outlined... READ MORE

On April 14, 2017, the Centers for Medicare & Medicaid Services (“CMS”) issued a proposed rule addressing several potential changes to the health care delivery system, including physician-owned hospitals (“Proposed Rule”). As a part of this Proposed Rule, CMS is also seeking comment regarding the current restrictions on physician-owned hospitals and how these restrictions affect... READ MORE

CMS issued a survey and certification letter, dated April 16, 2017, announcing their intention to publish proposed changes on April 28, 2017 that will require accreditation organizations (“AOs”) (i.e., TJC, DNV, HFAP and CIHQ) to post provider/supplier survey reports and plans of corrections from CMS-approved accreditation programs on their website. CMS is also proposing... READ MORE

Ordinarily, CMS will calculate the MIPS final score for a practice group’s physicians on an individual or group basis.[1] However, physicians participating in a “MIPS APM” are subject to a significantly different scoring methodology – the “APM scoring standard.” This article: (1) outlines CMS’s “snapshot” process for determining which physicians CMS will score using... READ MORE