01/03/2012 - Physician Payment Sunshine Act Reports Delayed by CMS; Proposed Rule Includes Physician Owned Distributorships
The Centers for Medicare and Medicaid Services (CMS) has delayed the start date for data collection of payments made to physicians and teaching hospitals by drug and device manufacturers and group purchasing organizations (GPOs).
09/21/2011 - CMS and OIG Respond to Senate Inquiry on Physician-Owned Distributorships
The Centers for Medicare & Medicaid Services (CMS) and the Office of Inspector General (OIG) for the U.S. Department of Health & Human Services (HHS) have responded to the U.S. Senate’s request for information on physician-owned distributorships (PODs).
08/30/2011 - Florida Fines Medicaid HMO for Failing to Report Suspected Fraud by Providers
The Florida Agency for Health Care Administration (“AHCA”) earlier this month fined Humana $3.4 million for failing to promptly report suspected cases of Medicaid fraud and abuse by others, as required by statute and Humana’s Medicaid HMO contract. Though many states have similar laws or regulations, this appears to be the first enforcement action of its kind in the nation.
07/19/2011 - Tax-Exempt Hospitals Face New Reporting Requirement of Community Health Needs Assessment
The Internal Revenue Service has proposed guidelines detailing how tax-exempt hospitals can conduct a Community Health Needs Assessment (CHNA), as required in the 2010 Patient Protection and Affordable Care Act (PPACA).
07/12/2011 - Texas Enacts New Mandates and Increased Penalties Regarding Electronic Health Records
Texas health care providers, health insurers and health clearinghouses face new mandates and increased penalties over the use of electronic health records (EHR) as a result of HB300, which was passed in the 2011 Texas legislative session and signed into law by Governor Rick Perry.
07/12/2011 - Texas Supreme Court Limits Use of Unrecoverable Medical Bills
On July 1, the Texas Supreme Court handed down an opinion that has the potential to impact any case where medical or health expenses are at issue. In the wake of the Court’s ruling, a plaintiff may not recover medical expenses for amounts that the plaintiff’s health providers bill but have no right to be paid. In addition, the Court held that such bills are inadmissible - including to show pain and suffering.
07/11/2011 - Company Settles with State Attorney General Over Failure to Disclose Data Breach
WellPoint, Inc. recently reached a settlement with the Indiana Attorney General following its failure to disclose a security breach involving consumers’ personal information.
07/06/2011 - Texas Legislation Further Limits Ban on Corporate Practice of Medicine
During the 2011 legislative session that just ended, Texas Governor Rick Perry signed into law a bill that allows rural hospitals to employ physicians, known as the “corporate practice of medicine,” despite the state’s long-standing ban on such practices.
06/27/2011 - U.S. Senate Conducts Further Inquiry into Relationships Between Medical Device Manufacturers and Physicians
Earlier this week, the U.S. Senate Finance Committee requested documents and information from a medical device manufacturer related to the financial relationship between the manufacturer and physicians who conducted clinical trials of one of its devices.
06/10/2011 - Senators Criticize OIG for Lack of Guidance on Physician Joint Ventures: Request Study on Physician Owned Distributorships
A bipartisan U.S. Senate committee has asked both the Centers for Medicare & Medicaid Services (CMS) and the Office of Inspector General (OIG) for the U.S. Department of Health and Human Services to study the proliferation of physician owned distributorships (PODs), citing a lack of regulatory guidance on how these arrangements square with existing federal law.
05/31/2011 - OCR Proposes Expansion of HIPAA and HITECH Rights: Industry to be Saddled With Large Costs; 20 Minutes to Read and Implement 24 Pages of Regulations?
The Office for Civil Rights (OCR) of the Department of Health and Human Services today proposed an expansion of the rights of individuals to obtain reports from health providers and insurers about how their protected health information (PHI) is used.
05/19/2011 - Will Pioneer ACOs Come to the Rescue, or is the Government Rearranging Deck Chairs on the Titanic?
The Centers for Medicare and Medicaid Services (CMS) announced the creation of so-called “Pioneer ACOs” on May 17 in an attempt to blunt heavy criticism over the draft regulations on Accountable Care Organizations (ACOs) issued on March 31, 2011 (the “Draft Regulations”). The Draft Regulations have been criticized due to their burdensome data collection requirements, large start-up costs, uncertain savings, possible losses and troublesome governance mandates.
05/13/2011 - FTC Orders Texas Doctors' Group to Cease Joint Price Negotiations with Insurers
Southwest Health Alliance (“Southwest”), an independent practice association with approximately 900 member-physicians, has agreed to a proposed order recently entered by the Federal Trade Commission (“FTC”) settling charges that it engaged in anticompetitive conduct in its dealings with insurers and other payors for the provision of physician services (collectively, “insurers” or “payors”).
05/12/2011 - Criminal Case Against Healthcare Executive Dismissed; Government Likely to Continue Aggressive Enforcement Efforts
A former GlaxoSmithKline attorney, Lauren Stevens, was acquitted on May 10 of all criminal charges stemming from her response to an FDA investigation. The acquittal, ordered by U.S. District Judge Roger W. Titus, is a stunning defeat for the government’s anti-fraud enforcement measures.
04/20/2011 - Medicare EHR Incentive Program Starts Attestation Phase: Physicians and Hospitals to Share $27 Billion Beginning May 2011
On April 18, 2011, the Centers for Medicare and Medicaid Services (CMS) began the attestation phase under its $27 billion Medicare EHR Incentive Program. Incentive payments for the meaningful use of electronic health records (EHR) will begin in May 2011 and will continue over the next several years.
04/04/2011 - ACOs Face Large Start-Up Costs, Uncertain Savings and Possible Losses Under Proposed Rules from CMS
Accountable Care Organizations (ACOs) will face large start-up costs under proposed rules issued on March 31, 2011 by the Centers for Medicare and Medicaid Services (CMS), with an uncertain outlook for savings and even possible losses.
03/15/2011 - Office for Civil Rights Announces Fines for Violations of HIPAA Privacy Rule
The Office for Civil Rights (OCR) of the U.S. Department of Health and Human Services has recently announced two significant enforcement actions against health care providers for violating the HIPAA Privacy Rule.
07/06/2009 - Health Care Legislation Update – Texas Legislature 81st Regular Session
The 81st Regular Session of the Texas Legislature passed several laws affecting hospitals, physicians, other health care providers, pharmaceutical companies, and medical device companies. The Health Care Practice Group of Haynes and Boone, LLP has compiled this quick reference tool on topics we believe will interest our clients.
09/04/2007 - CMS Final Disclosure Rules on Physician Ownership & Physician Coverage of Hospital
06/25/2007 - Healthcare Legislation Update--Texas Legislature 80th Regular Session
04/27/2007 - Federal and Texas Requirements for Disclosure of Physician Ownership
01/08/2007 - Hot Topics in Health Care for Texas' 80th Legislative Session
01/05/2007 - Texas Regulatory Developments: Hospital Licensing and Pain Management Rules
12/19/2006 - 2007 Other Miscellaneous Policies Client Alert
05/30/2006 - IRS Compliance Check Questionnaire Sent to 600 Tax-Exempt Hospitals
12/01/2005 - Reminder to Update Your Policies and Procedures for 2006
08/02/2005 - AmeriChoice False Claims Act Settlement and Impact on Future Medicare/Medicaid Managed Care Contract
06/20/2005 - Texas Healthcare Legislative Update - 79th Regular Session
Article 21.79F Does Not Prohibit Hospital Discount Programs
07/07/2004 - Proposed Regulations for Ambulatory Surgical Centers Licensed by the Texas Dept. of State Health Svc
03/08/2004 - Clarification on Payments for Referrals under the Anti-kickback Statute
09/02/2003 - Healthcare Legislative Update - 78th Regular Session
08/01/2003 - Managed Care: Prompt Payment, OON Payment, RBRVS-Based Fee Schedules and Appeals
10/31/2002 - Corporate and Professional Responsibility: Section 307 of the Sarbanes-Oxley Act of 2002
01/30/2002 - IRS Publishes Final Intermediate Sanction Rule
01/01/2000 - OIG Establishes New Safe Harbors for Antikickback Law
12/01/1999 - Fifth Circuit Decides "Solo" Qui Tam Action are Unconstitutional
11/12/1999 - Recent Developments Under the Texas Open Meetings and Open Records Act
11/01/1999 - U.S. Supreme Court Grants Review in Two Health Law Cases
09/01/1999 - Recent Developments in Health Law