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Publications Archive | Page 2 of 23 | Rivkin Radler
Recent Publications - Health Services
The Status of Telemedicine Reimbursement
December 20, 2017	| Benjamin P. Malerba | David E. Richman | Ada Kozicz | Health Services
Benjamin Malerba, David Richman and Ada Kozicz wrote an article published in Health eSource, a publication of the American Bar Association’s Health Law Section entitled, “The Status of Telemedicine Reimbursement: States’ Efforts to Incentivize Providers to Utilize Telehealth Technologies.” The article centers on the importance of creating legislation that will provide insurance reimbursement for telemedicine, as a means to …
December 13, 2017	| Benjamin P. Malerba | Ada Kozicz | Health Services
New York State Medicaid providers who claim, order or receive at least $500,000 from the Medicaid Program in any consecutive 12-month period have until December 31 to certify that they have implemented a compliance program aimed at detecting and preventing Medicaid fraud, waste and abuse. This requirement also applies to third-party billing companies that bill …
December 13, 2017	| Carol A. Hyde | Ashley S. Osadon | Health Services
October 16, 2017	| Health Services | Privacy, Data & Cyber Law
October 13, 2017	| Health Services | Compliance Investigations & White Collar
August 10, 2017	| Jeffrey P. Rust | Ashley S. Osadon | Health Services
August 9, 2017	| Benjamin P. Malerba | Ada Kozicz | Health Services
The U.S. Department of Health and Human Services, Office of Inspector General (“OIG”) recently entered into a settlement with AnMed Health (“AnMed”), a South Carolina hospital, for over $1.2 million for a violation of the Emergency Medical Treatment and Labor Act (“EMTALA”). The settlement serves as an important reminder and clarification on the obligations imposed …
NY’s Highest Court Hears Arguments on Physician-Assisted Suicide
July 21, 2017	| Benjamin P. Malerba | Ada Kozicz | Health Services
The New York Court of Appeals recently heard arguments in the Myers v. Schneiderman lawsuit, which challenges the legality of physician assisted suicide and whether a patient should have the right to choose a peaceful death on his or her own terms. As the law currently stands, New York Penal Law Section 125.15 prohibits physician-assisted …
.health Domain Name Now Available for Trademark Holders
June 8, 2017	| Health Services
Dothealth LLC, the company that operates the official registry for the .health domain name, has announced the first phase of .health’s public launch. During this initial “Sunrise Phase” trademark owners that are registered with ICANN’s Trademark Clearinghouse will have the first opportunity to register for the new domain name. This phase is open now through …
The U.S. Department of Health and Human Services, Office for Civil Rights (“OCR”) announced that St. Luke’s-Roosevelt Hospital Center Inc. (“St. Luke’s”) entered into a HIPAA settlement for $387,200 resulting from the impermissible disclosure of two patients’ protected health information (“PHI”). In addition to the settlement, St. Luke’s has entered into a specific Corrective Action Plan. …
May 25, 2017	| Health Services | Complex Torts & Product Liability
The New York State Office of Inspector General (“OMIG”) has released its Work Plan for its new fiscal year, April 1, 2017 – March 31, 2018. The Work Plan summarizes new and ongoing activities OMIG will prioritize in the upcoming year, all of which aim to achieve three over-arching objectives: (i) enhance provider compliance; (ii) …
Steven Shapiro was quoted in a Natural Products Insider article entitled, “Dietary Supplement Industry Blasts N.Y. Labeling Legislation.” In the article, Steven and other industry professionals weigh in on Assembly Bill 7607 which would require a dietary supplement in package form to bear a label containing the name and address of the manufacturer, distributor and …
May 12, 2017	| Health Services | Privacy, Data & Cyber Law
In a cautionary tale for all companies, but especially healthcare organizations, on May 12, 2017, multiple news sources reported that a broad cyberattack using ransomware caused substantial interference with critical systems across Europe, Russia and Asia. (See e.g., New York Times, BBC News and Silicon Angle.) According to the New York Times, the attacks were …
May 12, 2017	| Health Services
The US Department of Health and Human Services, Office for Civil Rights (“OCR”) recently announced that CardioNet, Inc., a cardiac monitoring services company, entered into a HIPAA settlement for $2.5 million resulting from the impermissible disclosure of unsecured electronic protected health information (“ePHI”). In addition to the settlement, CardioNet is required to engage in a …
Under New York’s medical marijuana program, which is tightly regulated by the New York Department of Health (“DOH”), patients with serious medical conditions can become certified for use of medical marijuana under the supervision of a licensed healthcare provider. As of March 2017, DOH added two enhancements to the program to increase patient access. First, …
April 18, 2017	| Health Services | Compliance Investigations & White Collar
On February 17th, the Department of Health and Human Services (“HHS”) released proposed new regulations aimed at stabilizing the individual and small business insurance marketplaces set up under the Affordable Care Act (“ACA”). According to the proposed rule, the marketplaces “have recently been threatened by issuer exit and increasing rates in many geographic areas.” The …
CMS and OMIG Provide Guidance on Combating Opioid Epidemic
The Healthcare Fraud Prevention Partnership (“HFPP”), in conjunction with the U.S. Department of Health and Human Services and the Centers for Medicare and Medicaid Services (“CMS”), has recently issued a White Paper that outlines recommended actions to reduce opioid misuse and opioid-use disorders (“OUDs”) in the United States. It has been estimated that prescription opioid …
For the first time in thirty years, the Substance Abuse and Mental Health Services Administration (“SAMHSA”), a branch of the U.S. Department of Health and Human Services (“HHS”), issued a final rule amending 42 CFR Part 2 (commonly referred to as “Part 2”) which governs the confidentiality of alcohol and drug abuse patient records. The …
February 6, 2017	| Health Services
Christopher J. Kutner was quoted in a Part B News article entitled, “Beyond QPP: Check Your Readiness for Insurer-Based Physician Incentive Programs.” Regarding non-federal physician incentive programs, Chris said they are about shifting to value-based payment options, so be sure you’re in a position to take it on. “Even without downside risk, you have to think about …
New York Passes New Law to Allow Outpatient Clinics and ASCs to Provide Off-Site Services
New York Governor, Andrew Cuomo, has signed a new legislation that may pave the way for outpatient clinics and diagnostic and treatment centers, which includes ambulatory surgery centers (“ASCs”), to provide primary care services to their patients off-site under limited circumstances. The new law, codified in the Public Health Law § 2803(11), requires that the …
OIG Releases Work Plan for 2017
The Department of Health and Human Services, Office of Inspector General (“OIG”) has released its Work Plan for Fiscal Year 2017 (the “Plan”). The Plan, available through the OIG website, summarizes new and ongoing audits, investigations and evaluations that OIG will prioritize in the upcoming year. Some of the new initiatives that OIG intends to …
Since its enactment six years ago, the Patient Protection and Affordable Care Act (the ACA) has faced numerous challenges from Republicans attempting to repeal the law. Though previous efforts, through both legislation and litigation, have been unsuccessful, the election of Donald Trump and a Republican-controlled Congress likely portends at least a partial repeal of the …
November 18, 2016	| Health Services | Compliance Investigations & White Collar
Since its enactment six years ago, the Patient Protection and Affordable Care Act (the “ACA”) has faced numerous challenges from Republicans attempting to repeal the law. Though previous efforts, through both legislation and litigation, have been unsuccessful, the election of Donald Trump and a Republican-controlled Congress likely portends at least a partial repeal of the …
New York State Medicaid providers who claim, order or receive at least $500,000 in any consecutive 12-month period from the Medicaid Program are required to implement a compliance program aimed at detecting and preventing Medicaid fraud, waste and abuse. This requirement also applies to third party billing companies that bill or receive the threshold amount …
CMS Offers Flexibility for Physician Participation in MACRA
Pursuant to the Medicare Access and CHIP Reauthorization Act of 2015 (“MACRA”), in April 2016, the U.S. Department of Health and Human Services issued a proposed rule that will require physicians who receive Medicare payments to participate in one of two payment programs: (1) the Merit-Based Incentive System (“MIPS”); or (2) the Alternative Payment Models …
Pursuant to a final rule issued by the U.S. Department of Health and Human Services (the “HHS Rule”), certain health care providers covered by Section 1557 of the Affordable Care Act (“Section 1557”) will be required to post nondiscrimination notices and taglines by October 16, 2016. Section 1557 prohibits discrimination on the basis of race, …
HIPAA Phase 2 Audit Protocol: Would Your Client Pass the Test?
September 22, 2016	| Health Services
Benjamin Malerba’s and Ada Kozicz’s article entitled HIPAA Phase 2 Audit Protocol: Would Your Client Pass the Test was published by the American Bar Association. The United States Department of Health and Human Services’ Office for Civil Rights (OCR) recently released its protocol for the next phase of audits that will be conducted throughout the second …
September 20, 2016	| Compliance Investigations & White Collar | Health Services
August 16, 2016	| Health Services | Professional Liability | Privacy, Data & Cyber Law
Federal and state regulators are bringing more and more enforcement proceedings to challenge the adequacy of corporate privacy practices. Although the best course for businesses is to be proactive and develop privacy rules that meet all applicable requirements before government steps in, a review of various privacy-related settlements that agencies recently have reached suggests a …
The Centers for Medicare & Medicaid Services (“CMS”) recently released a proposed rule that would implement Section 603 of the Bipartisan Budget Act of 2015 (the “Act”) and could significantly limit payments made under the Hospital Outpatient Prospective Payment System (“OPPS”), effective January 1, 2017. Specifically, the proposed rule would greatly affect Medicare payment for …
July 20, 2016	| Health Services | Corporate
July 14, 2016	| Health Services | Compliance Investigations & White Collar
May 26, 2016	| Health Services
A new bill has been introduced in the New York Senate that would require the Department of Health to promulgate rules governing all upper endoscopic procedures, including all examinations of vocal cords, esophagus, and stomach that utilize a flexible endoscopic instrument. Approximately ten million upper endoscopic procedures are performed in the United States each year. …
The New York State Office of the Medicaid Inspector General (“OMIG”) released its Work Plan for fiscal year 2016-2017 (the “Plan”) summarizing new and ongoing activities that OMIG will prioritize in the upcoming year. The Plan includes auditing, outreach and compliance initiatives to enhance Medicaid beneficiaries’ access to high-quality and cost-effective health care and prevent …
Phase 2 HIPAA Audits and Secure Disclosure of Patient Information
I. Department of Health and Human Services Commences Phase 2 of HIPAA Audit Program As part of its efforts to minimize risks to consumers created by the increased use of health information technology, and as required by the Health Information Technology for Economic and Clinical Health Act (“HITECH”), the U.S. Department of Health and Human …
April 15, 2016	| Health Services
Introduction Established the by Patient Protection and Affordable Care Act, the Medicare Shared Savings Program was designed to provide better care for individuals, better health for populations, and lower growth in expenditures through the investment in infrastructure and redesigned care delivery.¹Early in the development of the Shared Savings Program, it was apparent that such arrangements, …
Department of Health and Human Services Proposes Changes to Confidentiality Rules for Substance Abuse Patient Records
April 12, 2016	| Health Services
The Substance Abuse and Mental Health Services Administration (SAMHSA), a branch of the federal Department of Health and Human Services (HHS), has published a proposed rule that would amend 42 CFR Part 2 (commonly referred to as “Part 2”) which governs confidentiality of drug and alcohol abuse patient records. Part 2 was last revised in …