In the June 2010 issue of the Highmark PRN, Highmark announces that its Concurrent Care Guidelines have changed. The article does not explain the nature of the change, so it is important for all providers to review the policy as it now exists to determine how it applies to them.
Michael Cassidy
HITECH Breach Notification Final Rule Update
By Michael Cassidy on
Posted in HIPAA, HIT, and EHR
Contributed by Lee Kim
412.594.3915, lkim@tuckerlaw.com
The US Department of Health and Human Services ("HHS") is withdrawing the breach notification final rule under HITECH from OMB review to allow for further consideration, given the Department’s experience to date in administering the regulations. This is in response to the public comments received in light of the…
Getting in compliance with HIPAA
By Michael Cassidy on
Posted in HIPAA, HIT, and EHR
Contributed by Lee Kim
412.594.3915, lkim@tuckerlaw.com
Under HIPAA, both covered entities (e.g., health plan, health care clearinghouse, and health care providers) and business associate (i.e., individuals or entities that use or disclose protected health information ("PHI") on behalf of the covered entity) are required to comply with the Privacy and Security Rules. The HIPAA…
Scampone v. Grane Healthcare: Nursing Home Liability
By Michael Cassidy on
Posted in Long Term Care
In Scampone v. Grane Healthcare Company and Highland Park Care Center, the Superior Court of Pennsylvania reversed and remanded the trial court decision regarding nursing home liability, holding that a nursing home, just like a hospital or health maintenance organization, could be subject to corporate liability for negligence, in addition to vicarious liability for…
CMS Proposes Nursing Home Voluntary Disclosure Rules
By Michael Cassidy on
Posted in Compliance, Long Term Care
On July 12, 2010 CMS published the proposed rules to implement the 50% Civil Money Penalty (CMP) reductions for nursing homes that self-report compliance violations. The potential for the 50% reductions was enacted by Section 6111 of the Patient Protection and Affordable Care Act (PPACA), and is available under the following conditions:
1. The nursing home…
California Federal Court Denies Attorneys Fees in HCQIA Case
By Michael Cassidy on
Posted in Credentialing and Peer Review
Fox v. Good Samaritan presents two interesting variations on issues commonly raised in peer review cases. The case originated 10 years ago and arises out of the suspension of Dr. Fox after he refused to designate a coverage physician with clinical privileges equal to his own. When Good Samaritan Hospital suspended his clinical privileges, following medical staff…
Tucker Arensberg Announces New Web Site Launch
By Michael Cassidy on
Posted in Legal News
Tucker Arensberg is pleased to announce the launch of our new web site: www.tuckerlaw.com. The site has been redesigned to serve as an information center to more effectively assist our clients and visitors. We hope that you will visit www.tuckerlaw.com.
Regional Health Care Fraud Summit
By Michael Cassidy on
Posted in Medicare & Reimbursement
The U.S. Department of Health and Human Services ("HHS") has approved a request by the State of Florida to get access to Medicaid data so they can use data mining techniques to identify suspicious patterns in claims according to a speech given by Secretary Sebelius as part of the Regional Health Care Fraud Summit in…
CMS Releases Proposed 2011 Medicare Physician Fee Schedule
By Michael Cassidy on
Posted in Medicare & Reimbursement
CMS published the payment policies under the 2011 Medicare Physician Fee Schedule on Tuesday, January 13, 2011. The Med Law Blog will be posting comments on significant provisions over the next several weeks. Please let us know if there is a particular issue you would like addressed.
CMS Releases Proposed ASC 2011 Fee Schedule
By Michael Cassidy on
Posted in Medicare & Reimbursement