Articles and Blogs

Two recent federal court decisions have changed the landscape of off-label prescription drug marketing by pharmaceutical companies.  While providers may prescribe U.S. Food and Drug Administration (“FDA”)-approved drugs for off-label uses, pharmaceutical companies and their representatives are prohibited from promoting the use of FDA-approved drugs off-label as the Federal Drug and Cosmetic Act (“FDCA”)... READ MORE

Executive Summary On June 27, 2013, the Department of Health and Human Services Office of Inspector General (“OIG”) posted advisory opinion 13-06 (“AO”) in which it considered whether a proposal by a licensed offeror of Medigap policies to indirectly contract with hospitals for discounts on otherwise applicable Medicare inpatient deductibles for its policyholders and... READ MORE

On July 11, 2013, the Department of Health and Human Services (“HHS”) announced that it reached a settlement with a large national health insurance company (“Company”) stemming from alleged violations under the Health Insurance Portability and Accountability Act (“HIPAA”) Privacy Rule. The HHS Office for Civil Rights (“OCR”) initiated its investigation after the Company... READ MORE

On June 6, 2013, the United States District Court of the Northern District of Indiana granted a motion for summary judgment for an Indiana hospital, holding the Indiana Peer Review Statute grants immunity in the earliest stages of an initial (or “pre-peer review”) investigation and during communications regarding physician credentialing. This case provides reassurance... READ MORE

Executive Summary On June 13, 2013, the Department of Health and Human Services Office of Inspector General (“OIG”) posted Advisory Opinion 13-03 (“AO”), in which it considered whether a clinical laboratory’s proposal to contract with physician practices to enable the practices to provide clinical lab services to their non-federal health care program beneficiaries only,... READ MORE

On June 13, 2013, the Department of Health and Human Services (“HHS”) announced that it reached a settlement with a California medical center (“Medical Center”) stemming from alleged violations under the Health Insurance Portability and Accountability Act (“HIPAA”) Privacy Rule. The settlement follows an investigation by the HHS Office for Civil Rights (“OCR”) that... READ MORE

Executive Summary On May 17, 2013, the Centers for Medicare and Medicaid Services (“CMS”) published Change Request 8219 (Transmittal 465) (“CR 8219”) announcing new guidance on the use of rubber stamp signatures. For medical review purposes, Medicare requires providers to authenticate services provided or ordered with a handwritten or electronic signature. Currently, CMS does... READ MORE

Introduction What Is  a Scribe?  A scribe is a documentation assistant.  A scribe records, in “real time,” facts and events that occur between a patient and a physician or other practitioner1 (“Physician”) during a patient encounter.  In a hospital emergency department, the scribe accompanies the Physician to the treatment area and records in the electronic... READ MORE

Please be advised that the Wisconsin Division of Quality Assurance (“DQA”) has requested your response on the new online automated caregiver background check process for the four-year renewal background checks requirements by May 31, 2013. READ MORE

One of the more difficult tasks facing medical staff leadership is determining when and how to respond to complaints of unprofessional physician behavior. A physician’s clinical competence can be assessed objectively, relying on case reviews by physicians in the same specialty area and accepted standards of care. Conducting such reviews are well within the... READ MORE