New Tools Help Providers Become Smarter Users of Electronic Health Records Systems

Posted in Electronic Health Records & Medical Records

Healthcare providers excel at providing care to their patients, not designing IT strategies. Even so, with the trend toward value-based payments increasing, more healthcare providers have turned to electronic health records (EHR) systems to help them fine-tune practice efficiency and improve patient outcomes.

The EHR management systems options from which to choose can be dizzying, yet few decisions have so great an effect on a provider’s daily operations. As a result, the U.S. Department of Health and Human Services recently released two free tools that aim to help providers get the most out of their EHR systems. Continue Reading

Best Practices for Safeguarding Protected Health Information in Inclement Weather

Posted in HIPAA, Privacy, and Data Security

As the East Coast prepares for the arrival of Hurricane Matthew, covered entities and business associates should take the opportunity to remind their workforce members to safeguard protected health information (PHI) that is in paper form. Certainly, HIPAA requires covered entities and business associates to protect and secure PHI at all times. However, healthcare providers that deal with volumes of records (and particularly those relying heavily on paper records) should take extra precaution in preparation for inclement weather that may involve wind and water damage.  Covered entities and business associates should remind and advise their workforce members as follows:

  • PHI in paper form should be secured in locked file cabinets (where it will be less prone to wind and water damage) and should be kept separate from other paper documents.
  • Consider storing physical PHI a locked file room or other locked interior room that can be used for storage so that it is contained in a secure interior location (and again less prone to wind and water damage).
  • Workforce members, including physicians and other ancillary providers, should not remove PHI in paper form from the premises unless absolutely necessary.

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The Florida Agency for Health Care Administration Releases an Invitation to Negotiate for a Vendor to Provide an All Payor Claims Database to Florida Consumers

Posted in Healthcare Law

The Florida Agency for Health Care Administration (AHCA) released ITN 003-16/17 (the “ITN”) to select a vendor to provide All Payer Claims Database (APCD) services pursuant to section 408.05(3)(c), Florida Statutes. The ITN, published on September 26, 2016, contains a tight time-frame for the submission and evaluation of responses to it. While written inquiries regarding the ITN must be submitted to AHCA by 2:00 on October 3, 2016, completed responses to the ITN must be received by AHCA by 2:00 on November 7, 2016. It is anticipated that AHCA will post its notice of intent to award the APCD vendor contract on January 17, 2017, with the anticipated term of the contract to run for five (5) years, from February 1, 2017 through January 31, 2022.  Continue Reading

The Changing Meaning of Healthy: FDA Seeks Public Input About Healthy Foods

Posted in Healthcare Law

In the 1990s, food had to be low in fat in order to be considered healthy. Those were the days of Snack-Wells cookies and fat-free salad dressings. How times have changed. Now health professionals consider many higher-fat foods such as almonds, avocado, eggs, and salmon to be healthy. Conversely, some low-fat but artificial, processed foods are no longer deemed healthy. Continue Reading

CMS Postpones Pre-Claim Review Demonstration for Home Health Services

Posted in Healthcare Law, Medicare & Medicaid

The Centers for Medicare & Medicaid Services (CMS) announced that it would postpone the initiation of the CMS Pre-Claim Review Demonstration for Home Health Services (the “Demonstration”) in Florida, which was scheduled to begin in October 2016. The start dates for Texas, Michigan and Massachusetts, which are also part of the Demonstration, have not yet been announced, but were originally scheduled to commence in Texas in 2016 and in Michigan and Massachusetts in 2017. Continue Reading

When a Discount May be a Kickback

Posted in Healthcare Law, Healthcare Litigation, Physicians

Healthcare providers of all kinds, as well as medical equipment suppliers, have traditionally relied upon discounts as a legitimate means of attracting patients and commercial clients without running afoul of the federal anti-kickback statute (AKS). Congress specifically created the discount “safe harbor” to the AKS years ago based on its policy of encouraging discounts that are properly disclosed as a means of reducing overall health care costs. However, the U.S. government filed a position paper in federal court this month contending that the discount safe harbor does not protect discounts that are conditioned on more than just the purchase of a product or service, such as conditioning the discount on a retailer’s efforts to convert patients to using a manufacturer’s products. Continue Reading

Former Home Health Agency Owner Sentenced to 20 Years for $57MM Medicare Fraud

Posted in Fraud & Abuse & False Claims Act, Government Affairs, Licensure & Regulatory, Healthcare Law, Healthcare Litigation, Medicare & Medicaid

The US Department of Justice announced that Khaled Elbeblaswy, the former owner and manager three Miami-area home health agencies, was sentenced to 20 years in prison and ordered to pay $36.4 million in restitution for his role in a $57 million Medicare fraud scheme. Continue Reading

The Board of Pharmacy’s 40 Hour Rule is Dead! Long live the 20 Hour Rule! Community Pharmacy Ownership Rule Change Creates new Opportunities

Posted in Government Affairs, Licensure & Regulatory, Healthcare Law

The Florida Board of Pharmacy (BOP) recently amended the rules regarding community pharmacy hours of operation to reduce required daily operating hours from 40 to 20 hours per week. As before, the hours have to be posted and the pharmacy must have a policy and procedure for transferring prescriptions and addressing emergency doses. Continue Reading

11th Circuit Awards Humana Double Damages Under Medicare Secondary Payer Act

Posted in Health Insurers & Managed Care Organizations, Healthcare Law, Healthcare Litigation, Medicare & Medicaid

Humana Medical Plan, Inc. v. Western Heritage Insurance Co., case number 15-11436.

Liability insurers beware, as the 11th Circuit held that Medicare Advantage Organizations (MAO) are entitled to the same rights Medicare itself would have in actions against primary payers for reimbursement of conditional healthcare treatment costs.  Continue Reading