HHS Puts Industry on Notice: OCR is Serious About HIPAA Enforcement

Posted by Jason Greis on March 2, 2011 under Articles | Be the First to Comment

On Feb. 22, 2011, the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) announced that it had issued a civil money penalty (CMP) of $4.3 million against Cignet Health of Prince George’s County, MD., the first imposition of a CMP by OCR for a violation of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule. Two days later, HHS announced that General Hospital Corporation and Massachusetts General Physicians Organization, Inc., collectively referred to as Mass General, agreed to pay $1 million to settle potential violations of the HIPAA Privacy Rule. Read More...

When MedPAC Speaks Congress Listens: What the Inclusion of MedPAC Health Care Delivery Reform Proposals in Health Care Reform Legislation Means for Physicians

Posted by Jason Greis on March 28, 2010 under Articles | Be the First to Comment

On March 1, 2010, the Medicare Payment Advisory Commission (“MedPAC” or the “Commission”) released its 2010 Report to the Congress: Medicare Payment Policy (the “Final Report”) recommending annual Medicare payment updates for Medicare fee-for-service (“FFS”) payment systems, including among others, hospitals (including both general acute care and long term care hospitals) and physicians.  MedPAC is an independent congressional agency established by the Balanced Budget Act of 1997 to formulate recommendations to Congress to address quality and cost-containment issues affecting the Medicare program and its beneficiaries.  Two reports, issued in March and June each year, are the primary outlets for MedPAC’s policy and payment system updates, which change base rates paid by Medicare for a unit of service provided by a FFS provider—for example, a hospital admission or a physician visit or procedure.  Recommended payment system updates are based on an assessment of payment adequacy that takes into account beneficiaries’ access to care, supply of providers, quality of care, providers’ access to capital and Medicare margins.  Read More...

Bringing the HEAT: DOJ and HHS Create Heath Care Fraud Prevention and Enforcement Action Team

Posted by Jason Greis on May 25, 2009 under Articles | Be the First to Comment

On May 20, 2009, the Department of Justice (DOJ) and Department of Health and Human Services (HHS) announced the creation of the Health Care Fraud Prevention and Enforcement Action Team (HEAT), a new interagency investigation and enforcement team. The creation of HEAT signifies an increased focus by DOJ and HHS on combating health care fraud. Read More...

OIG Bars Stark-Only Violations From Self-Disclosure Protocol

Posted by Jason Greis on May 22, 2009 under Articles | Be the First to Comment

Providers, including LTACHs and physicians, can no longer resolve potential Stark law-only violations through the HHS Office of Inspector General’s Provider Self-Disclosure Protocol, unless such violations are paired with Federal Anti-Kickback violations, according to the Office of the Inspector General’s recent open letter to providers.  The letter, signed by Inspector General Dan Levinson, also notes that providers will no longer be able to get past the OIG’s front door in this context unless they anticipate a minimum kickback settlement amount of $50,000.  Read More...

Stimulus Legislation Expands Privacy Regulation for Health Care Businesses

Posted by Jason Greis on March 2, 2009 under Articles | Be the First to Comment

Health care providers and any businesses that provide information technology services for them will be subject to much greater regulation of their information security practices as a result of a major component of the recent economic stimulus legislation. Known as the Health Information Technology for Economic and Clinical Health Act (or the “HITECH Act”), this portion of the federal economic stimulus package is the most expansive modification to the federal privacy and security rules for health-related businesses since the 1996 enactment of HIPAA. Read More...