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Rise in HIPAA Class Action Suits: Partnership HealthPlan of California

HIPAA itself does not contain a private right of action for individuals following unauthorized disclosures of medical information. Yet, HIPAA does not prohibit individuals from seeking remedies through state or other law. Each U.S. state’s tort law system can potentially allow individuals to pursue reparations when they are harmed by…

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Evolving HIPAA Regulations Will Shape the Future of OCR’s Enforcement Regime

On April 6th, 2022, a HIPAA-regulatory Request for Information (RFI) was released by the Department of Health and Human Services (HHS) Office for Civil Rights (OCR) soliciting feedback from the public for future rulemaking. The RFI seeks information on how the industry views “recognized security practices,” and on OCR’s compensating…

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Alarming Rate of Ransomware Data Breaches Calls for Increased Protection in Healthcare Industry

Participants in the healthcare industry have seen a multi-front threat related to their information security practices/healthcare data – increased enforcement and fines by the Department of Health and Human Services’ (HHS) Office for Civil Rights (OCR); increased scrutiny from plaintiffs’ attorneys and State Attorneys General; and increased threats from malicious…

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HHS Files Notice of Appeal to Oppose Texas District Court Ruling Striking Down Portions of the No Surprises Act Independent Dispute Resolution Process

On April 22, 2022, the Department of Health and Human Services (“HHS”), in conjunction with several other federal agencies, filed a notice of appeal in opposition to a Texas federal judge’s summary judgment ruling regarding the No Surprises Act (“NSA”). The underlying lawsuit was filed by the Texas Medical Association…

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HRSA Ends COVID-19 Uninsured Program

In an effort to combat the COVID-19 public health emergency (PHE), the Dept. of Health and Human Services (HHS) developed the Uninsured Program to provide claims reimbursement to health care providers for: (1) testing uninsured individuals for COVID-19; (2) treating uninsured individuals with COVID-19; and (3) administering COVID-19 vaccinations to…

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Federal Court Strikes Down Portions of the No Surprises Act Implementing Regulations

On February 23, 2022, the United States District Court for the Eastern District of Texas, Tyler Division, issued a Memorandum Opinion and Order,[1] which served to strike down certain portions of the federal No Surprises Act (“NSA”) related to the independent dispute resolution (“IDR”) process for resolving payment disputes between…

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Coverage by Insurance Companies and Group Health Plans of Over-the-Counter COVID-19 Tests – New Requirement Issued by Biden-Harris Administration as of January 15, 2022

As of January 15, 2022, to increase access to free testing for many Americans, the Biden-Harris Administration has required private insurance companies and group health plans to cover over-the-counter COVID-19 tests approved by the U.S. Food and Drug Administration (FDA). Consumers of over-the-counter COVID-19 tests will be paid either up…

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The Supreme Court Blocks a COVID-19 Vaccine Mandate for 84-Million Workers, but Upholds a COVID-19 Vaccine Mandate for Healthcare Workers

In June 2021, the Occupational Safety and Health Administration (“OSHA”) issued an Emergency Temporary Standard (“ETS”) that would require, amongst other things, employers with 100 or more employees to adopt a mandatory COVID-19 vaccination policy. OSHA’s mandatory vaccination policy would affect approximately 84 million employees. An overview of the OSHA…

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OIG Updates the Self-Disclosure Protocol: Key Changes

On November 8, 2021, the Office of Inspector General (“OIG”) issued multiple updates to the Health Care Fraud Self-Disclosure Protocol (“SDP”), incorporating legal changes made since the previous SDP revision in 2013. The OIG’s updated SDP may be accessed here. Below is an overview of the updates. By way of…

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HHS Issues Interim Final Rule Regarding Surprise Medical Billing

Recently, the U.S. Dept. of Health and Human Services (“HHS”), Dept. of Labor, Dept. of Treasury, and the Office of Personal Management jointly issued an interim final rule regarding surprise medical billing. The interim final rule, entitled “Requirements Related to Surprise Billing: Part 1” (the “Rule”) may be accessed here,…