The Department of Health and Human Services (HHS) has released a proposed rule that would modify the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule by allowing health care providers to make certain disclosures to the National Instant Criminal Background Check System (NICS).  The NICS aims to keep guns from being sold to those…

A Massachusetts-based dermatology practice recently agreed to pay $150,000 to settle claims that it failed to have sufficient policies and procedures in place to address a breach notification requirement under the HITECH Act.  The investigation was initiated following a report that an unencrypted thumb drive containing electronic protected health information of approximately 2,200 individuals was…

The Office of Inspector General (OIG) has amended the Safe Harbor Regulation regarding electronic health record (EHR) items and services. The primary purpose of the amendment is to extend the Safe Harbor, which was scheduled to expire on December 31, 2013, until December 31, 2021.

Obviously, congressional hopes that EHR would be fully implemented by…

President Obama Signs the Pathway for SGR Reform Act of 2013

–New Law Includes Physician Update Fix through March 2014–

On December 26, 2013, President Obama signed into law the Pathway for SGR Reform Act of 2013. This new law prevents a scheduled payment reduction for physicians and other practitioners who treat Medicare patients…

A strange result in Langenberg v. Warren General Hospital, suggests you should pay close attention to the termination language in hospital-physician employment contracts.

Warren General Hospital terminated Dr. Langenberg without cause specifically pursuant to the without cause provisions of his employment contract. Warren General Hospital nonetheless reported the termination as an adverse event to…

The AMA Wire reports the following action on the Medicare Physician Fee Schedule:

*3-month Medicare payment update approved for Jan. 1

*Congress has adopted a 0.5 percent update to Medicare payments for three months, following a bipartisan vote of 64 to 36 in the U.S.  Senate         Wednesday afternoon.

*The president is expected to sign…

I recently posted the SGR White Paper published jointly by the Senate Finance Committee and the House Ways and Means Committee. Earlier this week, both committees endorsed legislation enacting those concepts.

The section by section summary of the SGR Repeal and Medicare Beneficiary Access Improvement Act of 2013 is attached. Unfortunately, both the House and…

A new OIG Advisory Opinion 13-15, the OIG has resurrected the issue of whether awarding exclusive contracts to hospital based providers involves remuneration in exchange for referrals, because it grants the opportunity for access to an income stream.

In the text of OIG Advisory Opinion13-15, the OIG states as follows:

 “The OIG has stated

…

The House Ways and Means Committee and the Senate Finance Committee have jointly issued a White Paper proposing the repeal of the Medicare Sustainable Growth Rate Formula, entitled “SGR Repeal and Medicare Physician Payment Reform”.

The SGR white paper acknowledges that the Sustainable Growth Rate formula is “fundamentally broken” and that application…

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