On October 12, 2011, U.S. District Magistrate Cathy Bissoon of the United States District Court for the Western District of Pennsylvania issued an Opinion denying Highmark’s request for a preliminary injunction against UPMC, which injunction sought to restrain UPMC from publically discussing and stating that patients’ health care coverage could end as early as June … Continue Reading
The Henry J. Kaiser Family Foundation is publishing a series of articles on nationwide progress reports towards the establishment of health insurance exchanges. You can log onto their website for an update on all of the states, but I have attached a copy of the Pennsylvania report. … Continue Reading
The Department of Health and Human Services has issued a News Release describing how the Affordable Care Act Grants are working to help contain health insurance premium hikes. The Affordable Care Act earmarked $250,000,000 in health insurance rate review grants. This money is being awarded to states to allow them to do a variety of things to … Continue Reading
HEALTHCARE FUTURES — CONSIDERATIONS & IMPLICATIONS FOR EMPLOYERS Health Care Reform: What’s up next for Employers? Emerging health care reform mandates, regulations and guidelines are driving numerous changes to employer health benefits. Having dealt with the initial administration compliance requirements, employers are now turning their attention to the longer-term issues included in reform.… Continue Reading
The federal government will present oral arguments today to a three-judge panel at the 11th Circuit Court of Appeals in Atlanta for State of Florida et al. v. U.S. Department of Health and Human Services et al. (Docket No. 11-11021). The federal government has appealed a ruling by a Florida judge who declared the … Continue Reading
A total of 1,491 malpractice lawsuits were filed in 2010, according to a report released last week by the Administrative Office of Pennsylvania Courts. Court officials reported that 163 cases reached a jury, and 133 verdicts – 81 percent – favored the defense. Chief Justice Ronald Castille said there’s been a 45 percent decline in … Continue Reading
Although the ink is barely dry on the proposed regulations for Accountable Care Organizations (ACOs), there are already harbingers that ACOs may not be the Health Care Reform savior they were intended to be. First, a study by the American Hospital Association states that the estimate initially made by CMS for the cost of … Continue Reading
Important update today regarding Accountable Care Organizations participating in the Medicare Shared Savings Program (Shared Savings Program). Please click here to read more information.… Continue Reading
Contibuted by Paul J. Welk pwelk@tuckerlaw.com; 412.594.5536 The U.S. Department of Health and Human Services’ (HHS) Office for Civil Rights (OCR) has issued a Notice of Final Determination, marking the first civil money penalty issued by HHS for HIPAA Privacy Rule violations, finding that Cignet Health of Prince George’s County, Md., (Cignet) violated the Privacy … Continue Reading
Every once in a while we try to provide some information that is interesting, helpful and a little different than our usual fair. I have attached a link to an article provided by nursingschools.net describing amazing emerging advances in medical technology. For the readers who would like more of this type of information, I have added nursing.net … Continue Reading
Experts Say Medical Office Embezzlement Common At Medical Practices, Particularly At Start Of Year. American Medical News (1/17, Elliott) reported that medical office embezzlement "is common at medical practices, and experts say the risk is especially high at the beginning of the year." This is because "patients are paying an ever-larger share of their … Continue Reading
Proposed regulations for the Affordable Care Act were announced today. Insurers in all states are now required to publicly justify any unreasonable rate increases starting in 2011. For 2011, proposed rate increases of 10 percent or higher will be publicly disclosed and thoroughly reviewed. Links: http://www.hhs.gov/news/press/2010pres/12/20101221a.html http://www.whitehouse.gov/photos-and-video/video/2010/12/21/white-house-white-board-health-reform-rate-review http://www.ofr.gov/OFRUpload/OFRData/2010-32143_PI.pdf … Continue Reading
(CNN) — A Virginia federal judge on Monday found a key part of President Barack Obama’s sweeping health care reform law unconstitutional, setting the stage for a protracted legal struggle likely to wind up in the Supreme Court. U.S. District Judge Henry Hudson struck down the "individual mandate" requiring most Americans to purchase health … Continue Reading
DEPARTMENT OF HEALTH Amendments to Charges for Medical Records Under 42 Pa.C.S. 6152 and 6155 (relating to subpoena of records; and rights of patients), the Secretary of Health (Secretary) is directed to adjust annually the amounts which may be charged by a health care facility or health care provider upon receipt of a request … Continue Reading
The American Medical Association maintains a website for current information on healthcare reform – from a provider perspective. www.ama-assn.org/ama/home/index.shtml… Continue Reading
Contributed by Paul J. Welk pwelk@tuckerlaw.com, 412.594.5536 On December 7, the House of Representatives passed S. 3987, the Red Flag Program Clarification Act of 2010. The Red Flags Rule requires financial institutions and creditors to develop and implement a written identity theft program. This legislation would exempt physical therapists and other health care providers from the forthcoming … Continue Reading
On November 30, 2010 the U.S. Senate passed the Red Flag Program Act of 2010 (Senate Bill 3987 available at http://thomas.loc.gov/) which seeks to exempt certain health care providers from the Red Flags Rule. The bill will next be considered by the House. Please check back for future updates on this legislation.… Continue Reading
On November 15, 2010, the Internal Revenue Service, the Department of Labor, and the Department of Health and Human Services jointly issued an amendment to the interim final rules relating to status as a grandfathered plan under the Patient Protection and Affordable Care Act. With the amendment, insured group health plans are now able to … Continue Reading
In Kandel v. The Nebraska Medical Center, Dr. Kandel sought an injunction against the Medical Center for reporting Dr. Kandel to the National Practitioner Data Bank after surrendering his medical staff privileges while being under an investigation. The Nebraska Trial Court granted a Motion for Summary Judgment by the hospital and the Nebraska Appeals Court … Continue Reading
The 2011 Medicare Physician Fee Schedule adds an additional requirement to the in-office ancillary services exception of the Stark Rules. New Section 411.355(b)(7) requires that providers of MRI, CT and PET services must provide a written notice to the patient at the time of the referral, advising that the patient may receive the same services from … Continue Reading
As they do every year, the Internal Revenue Service released the dollar limits that apply to qualified retirement plans. There are three separate charts below that list the limits for 2011. The three charts are separated to identify the limits for: (1) defined contribution plans, (2) defined benefit plans, and (3) both defined contribution and defined benefit … Continue Reading
Contributed by Jo-Anne Mineweaser jmineweaser@tuckerlaw.com, 412.594.3920 The Patient Protection and Affordable Care Act (PPACA) requires employers to report the aggregate cost of healthcare coverage provided to their employees on Form W-2. The aggregate cost is to be determined in the same way that the “applicable premium” is determined under the COBRA rules. This requirement was … Continue Reading
