The Centers for Medicare and Medicaid Services (CMS) has signaled its intent to increase enforcement of the location requirements for critical access hospitals (CAHs). CMS created the CAH certification program to provide additional reimbursement for … [Continue reading]
Critical Access Hospital Reimbursement May Be In Trouble if CMS Changes Rules
August 16, 2013 By Leave a Comment
Copier Hard Drive Breach Costs Plan $1.2 Million
August 15, 2013 By Leave a Comment
Yesterday, HHS announced a new HIPAA related settlement with Affinity Health Plan for $1,215,780 related to PHI maintained on leased copy machines. This settlement follows an OCR investigation prompted by Affinity's breach report filed on April 15, … [Continue reading]
New Law Would Limit Liability for Innocent Billing Errors
August 9, 2013 By Leave a Comment
The Fairness in Health Care Claims, Guidance and Investigations Act, H.R. 2931 would amend the False Claims Act (“FCA”) by requiring that regulators satisfy procedural steps before embarking on costly fraud investigations. The Bipartisan … [Continue reading]
SRDP Settlement: Improper EHR Donation Arrangement Among Violations
August 8, 2013 By Leave a Comment
Last month CMS settled several violations of the self-referral statute (aka Stark Law) with an Ohio hospital, including a failure to appropriately structure a donation arrangement for electronic health records (EHR) . The hospital disclosed under … [Continue reading]
Former Hospital CFO Blows Whistle On Effort To Buy Medicaid Referrals
August 1, 2013 By Leave a Comment
Georgia recently joined a false claims act lawsuit alleging that Healthcare Management Associates, Inc. and Tenet Healthcare Corporation hospitals have been improperly paying for referrals for many years. According to the complaint, the hospitals … [Continue reading]
Hospital Medical Staff Lacks Capacity To Sue – Medical Staff Bylaws Are Not a Contract
July 29, 2013 By Leave a Comment
The Minnesota Court of Appeals recently issued a decision that, in Minnesota, hospital medical staffs do not have capacity to sue as unincorporated associations. In addition, the Court concluded that, at least in this case, medical staff bylaws do … [Continue reading]
PSBJ Article on HIPAA Interviews OMW Attorney David Schoolcraft
July 26, 2013 By Leave a Comment
The Puget Sound Business Journal issued an article today on HIPAA and the impact on business associates. The article interviewed Ogden Murphy Wallace Attorney David Schoolcraft because of his expertise in healthcare privacy law and health … [Continue reading]
Washington Certificate of Need Program Commences Rule Making: Consumer Transparency in Affiliations & Dialysis
July 24, 2013 By 1 Comment
The Washington State Certificate of Need Program has announced its commencement of the rule-making process related to hospitals and dialysis. This action is in response to the directive issued last month by Governor Inslee instructing the CN Program … [Continue reading]
Private Payors Attempt to Apply 2% Sequester to Providers – CMS Says “No” (Mostly)
July 23, 2013 By Leave a Comment
The recent sequester of federal spending triggered automatic, across the board cuts in the federal budget. Included in these cuts is a 2% reduction in Medicare reimbursement to providers. The cuts went into effect on April 1, 2013. In the … [Continue reading]
CA Surgeon Stripped of Medicaid Funding for Failure to Treat HIV Positive Patient
July 22, 2013 By Leave a Comment
On July 18th, the U.S. Department of Health and Human Services announced that a California surgeon who refused to treat a patient based solely on the patient’s condition as HIV positive would lose Medicaid funding. The surgeon had refused to perform … [Continue reading]
