$2.5 Million Settlement Involving Wireless Health Services Provider

On April 24, 2017, the U.S. Department of Health and Human Services, Office for Civil Rights (OCR), announced that CardioNet, a Pennsylvania-based supplier of Mobile Cardiac Outpatient Telemetry, had agreed to settle potential noncompliance with the Health Insurance Portability and Accountability Act. As part of the settlement, CardioNet agreed to pay $2.5 million and to implement a […]

New Telemedicine Bill

The North Carolina House of Representatives is considering a bill that would require health insurance coverage for telemedicine services, House Bill 283. The bill is intended to help improve the quality of care for persons in rural areas. In an interview with the Winston-Salem Journal, Donny Lambeth, the bill’s primary sponsor, suggested that North Carolina […]

Beware: HHS OIG Hotline Scam

Do not answer any phone calls that appear to be from the U.S. Department of Health and Human Services Office of Inspector General Hotline 1-800-447-8477. HHS OIG recently announced that its Hotline telephone number is being used as part of a new telephone scam. According to HHS OIG, the scammers represent themselves as HHS OIG Hotline […]

Are Your Business Associate Agreements Up to Date?

The Department of Health and Human Services (“HHS”) recently announced that Care New England Health System (“CNE”), a non-profit health system, has agreed to settle potential violations of the HIPAA Privacy and Security Rules. On November 5, 2012, Woman & Infants Hospital of Rhode Island (“WIH”), a covered entity member of CNE, notified HHS of […]

Medicare and Medicaid Program Integrity Activities Save $42 Billion

According to a recent report from the Centers for Medicare & Medicaid Services (CMS), program integrity activities saved nearly $42 billion from October 1, 2012, through September 30, 2014—an average savings of $12.40 for each dollar spent on Medicare program integrity alone. According to Shantanu Agrawal, M.D., Deputy Administrator and Director of the Center for […]

MACRA Proposed Rule

On April 27, 2016, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to implement the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The proposed rule would replace the Sustainable Growth Rate (SGR) formula and establish a new Quality Payment Program that “allows [physicians] to choose from two paths that […]

Warner Chilcott Ordered to Pay $125 Million

On April 15, 2016, U.S. District Court Judge F. Dennis Saylor IV ordered pharmaceutical company Warner Chilcott to pay $125 million to resolve criminal and civil liability arising from the illegal promotion of various drugs. According to the Department of Justice, from 2009 to 2013, under the guise of so-called “Medical Education Events,” Warner Chilcott […]

Phase 2 of HIPAA Audit Program

On March 21, 2016, the Office for Civil Rights (“OCR”) launched Phase 2 of its HIPAA Audit Program. In order to better examine compliance with the Privacy, Security, and Breach Notification Rules, OCR will conduct desk and onsite audits for covered entities and their business associates. Entities that are selected for an audit will be […]

New Payment Model for Medicare Part B Prescription Drugs

On March 8, 2016, the Centers for Medicare & Medicaid Services (“CMS”) announced a proposed rule to test new payment models for Medicare Part B prescription drugs. “Today, Medicare Part B generally pays physicians and hospital outpatient departments the average sales price of a drug, plus a 6 percent add-on. The proposed model would test […]

OIG Estimates that Maryland Claimed $16,015,005 in Unallowable Costs

On March 9, 2016, the Office of Inspector General (“OIG”) announced that Maryland’s Department of Health and Mental Hygiene (“State agency”) “did not always comply with Federal and State requirements when it claimed costs for communicable disease care services.” OIG reviewed a stratified random sample of 124 paid claim lines submitted between January 1, 2008, […]