Articles and Blogs

On January 7, 2016, the U.S. Department of Health and Human Services Office for Civil Rights (“OCR”) released new guidance clarifying an individual’s right to access his or her medical record under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”). On February 25, 2016, OCR released additional guidance explaining the permissible reasonable cost-based fees…Read More

The Indiana Court of Appeals in ESPN Inc. and Paula Lavigne v. University of Notre Dame et al. held the campus police department at Notre Dame, a private university, was subject to the Indiana Access to Public Records Act (“APRA”).  ESPN and Ms. Lavigne filed a complaint against the University’s Police Department alleging it was…Read More

HELP Committee Passes Mental Health Legislation On March 16, the Senate Health, Education, Labor and Pensions (“HELP”) Committee passed a set of bipartisan mental health and opioid abuse bills that include provisions relating to access to care, early intervention and shortages in the behavioral health workforce.

In a proposed rule issued on March 11, CMS formally unveiled plans for its Part B Drug Payment Model (the “Model”). The Model would significantly alter how Medicare pays for Part B drugs and biologicals. If finalized, the Model will affect hospital outpatient departments, physicians, nursing facilities and certain DME suppliers. Commencement and Duration of…Read More

The Sixth Circuit Court of Appeals, in US ex rel. Sheldon v. Kettering Health Network, affirmed the dismissal of a False Claims Act (“FCA”) suit alleging fraud based upon certifications of compliance with the HITECH Act and a data breach. The HITECH Act, or Health Information Technology for Economic and Clinical Health Act, encourages the adoption…Read More

CMS Proposes Overhaul of Part B Drug Payments On March 8, CMS announced a proposed rule to change the way it pays for billions of dollars of drugs covered by Medicare. The new project, run through the Center for Medicare and Medicaid Innovation (“CMMI”), would allow the government to vary what it spends on drugs…Read More

Wisconsin became the twelfth state to enact the Interstate Medical Licensure Compact (“Compact”) into law, which, once implemented, will allow eligible physicians the option of applying for a medical license through an expedited process in Wisconsin and other states participating in the Compact. With physician shortages increasing, the Compact is intended to expand access to health…Read More

On March 1, 2016, the Department of Justice (“DOJ”) released a statement describing a settlement with the United States’ largest endoscope distributor (“Company”) to resolve civil claims and criminal charges connected to payments and kickbacks made to physicians and hospitals. The Company agreed to pay a total of $623.2 million to settle the criminal penalties…Read More

Overview On March 1, 2016, the Centers for Medicare & Medicaid Services (“CMS”) issued a Proposed Rule that would make several sweeping changes to the Medicare screening and enrollment requirements for providers and suppliers. In particular, the Proposed Rule would require providers and suppliers to report certain affiliations with other providers/suppliers that may pose a…Read More

Executive Summary The Centers for Medicare & Medicaid Services (“CMS”) recently released a memo to Medicare Advantage and Part D plan sponsors (collectively, “Sponsors”) providing additional guidance regarding Compliance Program Effectiveness (“CPE”) training requirements applicable to a Sponsor’s first tier, downstream and related entities (“FDRs”), including a Sponsor’s contracted health care providers and subcontractors. In…Read More