On March 17, 2020, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) issued a policy statement in response to the 2019 novel coronavirus (COVID-19) outbreak and the HHS Secretary’s determination that a public health emergency has existed nationwide since January 27, 2020 (the “Policy Statement”).…
Small health care data breaches – those affecting fewer than 500 patients – that occurred in the 2019 calendar year must be reported to the Department of Health and Human Services’ Office for Civil Rights (OCR) by February 29, 2020. The HIPAA Breach Notification Rule requires HIPAA-covered entities to report…
Senate Bill 340, which would allow ‘remote pharmacies’ that are not staffed by an on-site pharmacist, cleared Michigan Legislature Wednesday, January, 8, 2020 on a 32-5 Senate vote. The bill is now waiting for Governor Gretchen Whitmer’s signature in order to be passed as law. SB 340 would allow the…
Due to the high volume of tips and complaints the Department of Health and Human Services (HHS) Office of Inspector General (OIG) receives – approximately 115,000 each year – the need for an efficient means of capturing these complaints was vital for OIG. Released to the public November 14, 2019,…
New York Governor Andrew Cuomo signed legislation on October 17, 2019 further reinforcing New York’s Surprise Medical Bill Law, originally enacted in 2014. That bill, the first of its kind in the nation, is intended to comprehensively protect New York consumers from surprise medical bills for services rendered by out-of-network…
By Adrienne Dresevic, Esq. and Carey Kalmowitz, Esq. of The Health Law Partners, P.C. The Centers for Medicare & Medicaid Services (CMS) issued a final rule that strengthens the agency’s ability to stop fraud by barring unscrupulous providers out of federal health insurance programs. This rule is unlike past rules…
An Ashland, KY addiction treatment specialist, Dr. Rose O. Uradu, and her substance abuse treatment center, Ultimate Care Medical Services, LLC d/b/a Ultimate Treatment Center, have agreed to pay $1.4 million to resolve civil allegations that they violated the Controlled Substances Act, and defrauded the Medicare and Kentucky Medicaid programs.…
On April 8, 2019, the American College of Physicians (“ACP”) released the clinical guideline, “Screening for Breast Cancer in Average-Risk Women: A Guidance Statement from the American College of Physicians” (the “Guideline”). The Guideline divides women into three categories based on age and offers breast cancer screening methodology guidance for…
In the recently released CY 2020 Outpatient Prospective Payment System (OPPS) proposed rule, the Centers for Medicare & Medicaid Services (CMS) introduced policies that, if finalized, would require hospitals to post a list of standard charges for items and services provided. This proposed rule updates the requirements set forth in…
On July 30, 2019, a federal jury in Detroit, Michigan, found a patient recruiter guilty for his role in a scheme involving approximately $1.3 million in fraudulent Medicare claims for home health care that were procured through the payment of illegal kickbacks. Following a six-day trial, Dominic Trumbo, 45, of…