Recent Indiana case illustrates the importance of carefully drafting reasonable non-competition and non-solicitation restrictive covenants to enhance their effectiveness and enforceability.Read More
The Centers for Medicare & Medicaid Services (CMS) issued a final rule on April 5, 2019, that allows Medicare Advantage (MA) plans to expand their telehealth benefits starting in plan year 2020. The legislation allows MA plans to include “additional telehealth benefits” that surpass the benefits allowed under Original Medicare in their bids for the...Read More
In January 2017, the U.S. Department of Health & Human Services (HHS) released a newsletter entitled “Understanding the Importance of Audit Controls.” Shortly after its release, HHS announced a $5.5 Million settlement, one of the largest reported settlement payments to date for violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The...Read More
On Feb. 11, 2016, the Center for Medicare and Medicaid Services (“CMS”) issued its long-awaited final rule on the mandatory reporting and return of overpayments, commonly known as “the 60-day rule.” Medicare and Medicaid providers, suppliers and managed care contractors are to report and return any overpayments within 60 days of their identification. Retention of...Read More
On October 30, 2015, the Centers for Medicare & Medicaid Services (“CMS”) announced a new final rule for services furnished under the Medicare Physician Fee Schedule on or after January 1, 2016. Among other things, the new final rule offers several clarifications intended to help reduce the burden on healthcare providers and facilitate compliance with...Read More
The U.S. Department of Justice (DOJ) recently reported that federal fiscal year (FFY) 2014 was a record-breaking year for judgments and settlements in civil cases involving health care fraud and abuse, particularly qui tam whistleblower actions under the False Claims Act (FCA). In total, DOJ reported that the Federal Government recovered $5.69 billion, with nearly 40%...Read More
As an attorney who specializes in health care law, I have had the privilege of representing hospitals and physicians on a daily basis throughout my legal career. I spend most days strategizing with and counseling health care clients, negotiating transactions, attempting to draft the perfect legal contracts and assisting them in complying with the many regulatory...Read More
In recent years, the health care industry has experienced significant growth in contractual relationships between physicians and health systems. This growth is likely to continue as hospitals will increasingly require physicians’ clinical services and expertise as their reimbursement becomes tied to quality. Practitioners should be aware that enforcement risk is also increasing and particular attention...Read More
Despite the Obama administration’s movement towards immigration reform, more and more employers are being audited to determine if they are employing illegal immigrants. In 2012, U.S. Immigration and Customs Enforcement (“ICE”) audited the I-9 forms of over 3,000 employers, up from only 250 employers just 5 years ago. Not only have employer fines increased from...Read More
Many providers transmit their patients’ Protected Health Information (“PHI”) in unsecured e-mails. Through audits, some providers have discovered that their employees routinely included patient PHI in both the subject line and body of e-mails sent internally and externally. In doing so, these providers could be exposed to HIPAA violations if employees send e-mails containing PHI...Read More