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Sixth Circuit Affirms Conviction and Sentence of Anesthesiologist for Fraud and Endangering Patients

On December 1, 2009, the Sixth Circuit affirmed the conviction of Dr. Jorge A. Martinez, an anesthesiologist, who was charged with illegally distributing controlled substances, mail fraud, wire fraud, and healthcare fraud, including two counts that resulted in the death of patients. In 2002, the FBI began investigating Dr. Martinez’s…

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Medicare Makes Major Changes to Coverage Requirements for Inpatient Rehabilitation Services

Requirements for Medicare coverage of Inpatient Rehabilitation Services will undergo a number of changes, effective January 1, 2010. Centers for Medicare and Medicaid Services (CMS) released a transmittal on October 23, 2009 detailing these changes, which include several new requirements for the patient admission process and ongoing recordkeeping. Admission will…

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Michigan Supreme Court Deciding HIPAA’s Impact in Liability Cases

Oral arguments began on November 3, 2009 in a case that will test whether defendants in medical liability lawsuits are permitted under HIPAA to conduct informal interviews with plaintiffs’ other treating doctors. The federal Health Insurance Portability and Accountability Act (HIPAA) protects private health information and preserves patient confidentiality. In…

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HIPAA Violation Results in Sixteen Firings in Houston

The Harris County Hospital District of Houston fired 16 employees last month for a major violation of the Health Insurance Portability and Accountability Act (HIPAA), which protects confidential patient information. The hospital district has not disclosed additional details about the violation, instead issuing a statement saying, “The Harris County Hospital…

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CMS Delays PECOS

On November 23, 2009, CMS sent a notice delaying implementation of its registration requirements for the Medicare Provider Enrollment, Chain and Ownership System (PECOS) which affects physicians and non-physician practitioners who order items or services for Medicare beneficiaries or who refer Medicare beneficiaries to other Medicare providers or suppliers, providing…

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2010 Home Health PPS Final Rule Addresses Program Integrity Issues

On November 10, 2009, the Centers for Medicare & Medicaid Services (CMS) issued a final rule to update the Medicare Home Health Prospective Payment rates for the 2010 calendar year (the “Final Rule”). The Final Rule continues with the previously promulgated 2.75 percent reduction to the home health prospective payment…