By James M. Burns In a February 26 speech before the Connecticut Bar Association, Federal Trade Commissioner Maureen Olhausen expressed strong opposition to proposed legislation that would create an antitrust exemption for collective negotiations with health insurers by otherwise competing health care providers. Describing such proposals, which have been introduced at both the federal and …
The 2014 OIG Work Plan: Select Provisions Applicable to Physician Practices
By Rose J. Willis The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) recently issued its 2014 Work Plan outlining its intended review activities of HHS Programs for 2014. This article summarizes certain portions of the 2014 Work Plan that are of considerable importance to physician practices. Security of Protected …
Continue reading “The 2014 OIG Work Plan: Select Provisions Applicable to Physician Practices”
Hearing Held on Pennsylvania’s Novel “Any Willing Insurer” Legislation
By James M. Burns On December 18, 2013, the Pennsylvania House Health Committee held a hearing on Pennsylvania House Bills 1621 and 1622, two bills that would require that any health provider in the state that operates as part of an integrated delivery system (i.e., a health system that also has its own health plan, …
Continue reading “Hearing Held on Pennsylvania’s Novel “Any Willing Insurer” Legislation”
CMS Issues Final Rule on Direct Access of Lab Test Results by Patients
By Rodney D. Butler On February 3, 2014, the Centers for Medicare and Medicaid Services (CMS) released a final rule that permits patients or their representatives to have direct access to the results of their lab tests. This rule change is significant because under the prior rule, labs could only release test results directly to …
Continue reading “CMS Issues Final Rule on Direct Access of Lab Test Results by Patients”
CMS Report Shows Some Medicare Cost Savings Through ACO Model
By Rodney D. Butler A report published last week by the U.S. Centers for Medicare and Medicaid Services (CMS) demonstrated, in the words of CMS, “encouraging results” in the reduction of healthcare costs to Medicare and improvement in the quality of care for over 5 million Medicare beneficiaries under the Affordable Care Act (ACA). Under …
Continue reading “CMS Report Shows Some Medicare Cost Savings Through ACO Model”
Mississippi Governor Rescinds Executive Order Requiring Blue Cross of Mississippi to Grant “In Network” Status to Excluded Hospitals
By James M. Burns In early November, Mississippi Governor Phil Bryant rescinded an Executive Order (Executive Order 1327), issued only weeks earlier, that would have compelled Blue Cross of Mississippi to continue to offer “in-network” status to several Mississippi hospitals with whom Blue Cross had terminated its relationship as a result of a contract dispute …
Providers: Prepare Your Breach Notification Policy!
By Rose Willis On December 26, 2013, Adult & Pediatric Dermatology, a dermatology practice located in Massachusetts, agreed to pay a $150,000 fine after it lost an unencrypted thumb drive containing over 2,000 patients’ health records, and for its failure to institute HITECH’s breach notification requirements in response to the loss. According to the notice …
Continue reading “Providers: Prepare Your Breach Notification Policy!”
“Any Willing Insurer” Legislation Introduced in Pennsylvania
By James M. Burns A significant number of states have “Any Willing Provider” statutes that require a health insurer to admit all requesting providers into the health insurer’s preferred provider network. While some of these statutes are limited in scope (covering only pharmaceutical providers), others require insurers to admit any “willing” hospital or physician that …
Continue reading ““Any Willing Insurer” Legislation Introduced in Pennsylvania”
HHS Delays NPP Amendment Requirement for Laboratories Regulated Under CLIA
By Scott Roberts Under the HIPAA Privacy Rule, a Covered Entity is required to revise its notice of privacy practices (“NPP”) where there is a material change to any of its privacy policies. The HIPAA/HITECH Omnibus Final Rule (the “Omnibus Rule”) issued earlier this year requires a number of changes to privacy policies that will …
Continue reading “HHS Delays NPP Amendment Requirement for Laboratories Regulated Under CLIA”
Getting to Know Dickinson Wright Healthcare Attorney Mark Wilson
As the healthcare world evolves, physicians are looking at various delivery system alternatives to ensure the longevity of their practices. Some will join a health system while others look for alternatives. One choice is a new trend in the healthcare field termed “Supergroups”. “Supergroups” are business entities made up of 30 to 200+ physicians and …
Continue reading “Getting to Know Dickinson Wright Healthcare Attorney Mark Wilson”