As of October 1st, the federal government is officially shut down after Congress failed to pass funding legislation. While the biggest direct impact will certainly be on furloughed federal workers and government agencies, if your practice relies on Medicare or Medicaid, or you are involved in research, there are ripple effects worth understanding.
The U.S. Department of Health & Human Services (HHS) issued a Final Rule in April 2024 amending the HIPAA Privacy Rule to strengthen protections for reproductive health care information. The goal was to prevent medical records from being used to investigate or penalize patients or providers for seeking or offering lawful reproductive care.
However, in
On July 14, the Centers for Medicare & Medicaid Services (CMS) released its proposed rule for the 2026 Physician Fee Schedule. As expected, there are several meaningful updates that providers, practices, and health systems should be aware of.
One of the more significant changes is that CMS will split the conversion factor into two separate
There is almost universal agreement regarding predictions for 2022 federal enforcement in the following areas:
CMS published the 2015 Open Payment Data on June 30, 2015. This is the link to the notice and the CMS site: https://openpaymentsdata.cms.gov/
CMS has presented tables in its press release showing the highest paid specialties and highest paying companies. Over the last two years, Novartis has paid approximately $842 million to 344,000 recipients, which
CMS has issued the final regulations to implement that section of the Affordable Care Act amending the Social Security Act to provide that retention of identified overpayment could be a false claim and be subject to both the False Claims Act (FCA) and the Civil Money Penalty Act (CMP).
ACA § 6402(a) established new Social
On December 18, 2015, the Federal Trade Commission (FTC) announced a settlement with Keystone Orthopaedic Associates Specialists and Orthopaedic Associates of Reading, LTD, which were two of six orthopedic practices in Berks County, Pennsylvania that merged in 2011.
The FTC initiated the Complaint because they believe the merger of the practices eliminated competition among orthopedists
PBGH just recently sent out a client alert regarding UPMC/Highmark Continuity of Care Settlement as follows: UPMC and Highmark have announced a settlement agreement that addresses the Consent Decrees’ Continuity of Care provision. This settlement will govern continuity of care beginning January 1, 2016 until the end of the Consent Decrees on June 30, 2019.
On October 21, 2015 the Department of Health and Human Services Office of Inspector General posted Advisory Opinion No. 15-13. This Opinion relates to a request for Advisory Opinion about a plan to offer free van shuttle services to certain medical facilities in an integrated health system. The Office of Inspector General (the “OIG”)
In September, 2015, OCR and HHS issued a press release announcing a Resolution Agreement with the Cancer Care Group, P.C., which included entry into the agreement, the adoption of a robust compliance plan, and the payment of a $750,000 penalty. The settlement arose out of an incident involving the theft of an employee laptop containing