Category Archives: Hospitals & Health Systems

Subscribe to Hospitals & Health Systems RSS Feed

The American Health Care Act, the Sequel Receives Its CBO Grade

Perhaps the high fives in the Rose Garden of the White House a few weeks ago may have been a bit premature. On Wednesday, May 24, 2017, the non-partisan Congressional Budget Office (CBO) released its analysis of the revised American Health Care Act (AHCA), and the review contained positive budgetary news, but the overall impact of the bill on health … Continue Reading

Global Ransomware Attack Makes Healthcare Organizations Wanna Cry

As has been widely reported, on May 12, 2017, organizations around the world, including Britain’s National Health Service, found their data held hostage by actors using a new variant of ransomware called WannaCry. According to news reports, 200,000 computers in more than 150 countries have been hit by the cyberattack which appears to be spread by phishing emails. There are … Continue Reading

Potential Implications to the ACA Under the Incoming Republican Administration – Part III: Hospitals

President Trump has been clear in his intention to repeal the ACA. In fact, among President Trump’s first executive orders was one seeking to “minimize the economic burden” associated with the Patient Protection and Affordable Care Act (ACA). In addition to calling for its prompt repeal, he calls upon the executive branch to minimize the regulatory burdens of the ACA … Continue Reading

Deciphering Florida’s New Laws on ARNP and PA Controlled Substance Prescribing

During the 2016 legislative session, Florida granted authority to both advanced registered nurse practitioners (ARNPs) and physician assistants (PAs) to prescribe controlled substances, subject to approval by their supervising practitioner. This change brings these professionals’ authority in line with what most other states allow. However, this was not a complete grant of prescribing authority and, as explained below, leaves these … Continue Reading

HIPAA Audits – Phase 2: On-Site Audits Scheduled for First Quarter of 2017

Covered Entities and Business Associates may be ringing in the New Year with the prospect of responding to on-site HIPAA audits by federal regulators. The U.S. Department of Health and Human Services Office for Civil Rights (OCR) has announced that a certain number of comprehensive on-site HIPAA compliance reviews will be done over the first quarter of next year. Details … Continue Reading

HHS Issues Final Non-Discrimination Rules for Healthcare Providers

Healthcare providers and others who receive federal financial assistance are now subject to new non-discrimination rules and notice requirements under the Affordable Care Act. The new regulation prohibits discrimination in healthcare programs and activities on the basis of race, color, national origin, age, disability and sex – including pregnancy, gender identity, and sex stereotyping. The new rule also encompasses the … Continue Reading

Brief Reprieve Before Hospitals Must Provide Medicare Patients with “Observation” Notices

Hospitals now have additional time before they must meet federal requirements to provide written notice to Medicare patients who are receiving observation services. Congress passed the Notice of Observation Treatment and Implication for Care Eligibility Act (NOTICE Act) in 2015, in response to patient confusion and complaints related to hospital observation stays. The rules were expected to be effective in … Continue Reading

Illinois’ Largest Health System Agrees to Stringent HIPAA Breach Settlement

The Department of Health and Human Services Office for Civil Rights (OCR) announced on August 4, 2016, a settlement agreement with Advocate Health Care Network, an integrated healthcare system with ten hospitals and a non-profit medical group of more than 1,500 physicians in Illinois (the System or Advocate). The System agreed to adopt a corrective action plan and to pay … Continue Reading

Attention Employers: Action Required Before Having Employees or Contractors Sign Non-Disclosure Agreements

In May, President Obama signed the federal Defend Trade Secrets Act of 2016 into law, the details of which we reported in a recent Akerman Practice Update. The Act allows companies for the first time to bring trade secret theft claims under federal law. One of the many important provisions of the law that employers should not overlook is … Continue Reading

Accountable Care, Non-Profit Status and the Dangerous Ripple Effect it May Cause

On April 8, 2016, the Internal Revenue Service (IRS) released Private Letter Ruling (PLR) 201615022, which denied tax-exempt 501(c)(3) status to a commercial accountable care organization (ACO). This ruling marks the first time the IRS published any guidance regarding commercial ACOs. The last guidance from the IRS regarding ACOs came in 2011 and was related to ACO participation in … Continue Reading

Lights, Camera, Settlement: OCR says a picture is worth $2.2 million

A New York hospital has settled with the U.S. Department of Health and Human Services Office for Civil Rights (“OCR”) for $2.2 million after allowing a TV crew for the ABC documentary series “NY Med” to film patients receiving medical treatment without obtaining prior authorization from the patients or their representatives. The estate of one those patients is also suing … Continue Reading

Not a Check-the-Box Exercise: Failure to Have Signed BAA Results in Substantial Fine

A group practice that was the victim of a silver-harvesting scam has agreed to pay the U.S. Department of Health and Human Services (“HHS”) $750,000 to settle charges that it released protected health information (“PHI”) of its patients to a third party vendor without first obtaining a written business associate agreement. Raleigh Orthopaedic Clinic, P.A. (the “Clinic”) provided x-ray films … Continue Reading

Florida’s Adoption of Federal Exemptions for Wholesale Drug Distribution May Benefit Pharmacies, Practitioners and Hospitals

The 2016 Florida Legislature enacted substantial legislation (Ch. 2016-212, Laws of Florida) to bring Florida’s Drug and Cosmetic Act (Ch. 499, Florida Statutes) in line with the federal Drug Supply Chain and Security Act (“DSCSA”). Since the DSCSA preempts state law, the changes were necessary to avoid confusion between the state and federal exemptions to the term “wholesale … Continue Reading

Prepare for the Unexpected with Data Storage and Retrieval

Last week, a federal court in Illinois encountered another example of unexpected events causing problematic privacy and data storage implications for a healthcare company. The non-profit organization responsible for maintaining the MetroChicago Health Information Exchange (the HIE) filed suit against its information technology support contractor and the contractor’s owner to prevent the contractor’s plan to destroy all client data after … Continue Reading

Shhh….OCR Releases New HIPAA Audit Protocol

Just in time for the Phase 2 audits, the Department of Health and Human Services Office for Civil Rights (OCR) quietly posted the updated HIPAA Audit Protocol on its website. The new audit protocol has been updated to include business associates who became subject to HIPAA following the 2013 HIPAA Omnibus Final Rule. The protocol covers Privacy Rule, Security Rule … Continue Reading

Federal Court finds “Systemic Failure” in Processing of Administrative Appeals for Medicare Reimbursement Claims

A win for efficiency: The AHA suit may force shorter adjudication times for Medicare administrative appeals. In 2014, the American Hospital Association (AHA), along with three hospital systems, filed suit against the U.S. Department of Health and Human services, alleging that the lengthy adjudication time for administrative appeals of Medicare claim denials caused severe economic harm.  See, American Hospital Continue Reading

CMS Updates Two-Midnight Rule

The Centers for Medicare and Medicaid Services (CMS) has revised the two-midnight rule to create an exception that will allow payment under Medicare Part A for certain medically necessary hospital stays that do not extend across two midnights. The new rule is effective for admissions after January 1, 2016, and permits payment on a case-by-case basis, supported by the admitting … Continue Reading

Protecting the Blood Supply During a Future Ebola Outbreak

It has been more than a year and a half since the Ebola outbreak began racing across western Africa. According to the U.S. Centers for Disease Control & Prevention (CDC), more than 28,000 people have been infected. Although the United States had very few Ebola patients, the Food and Drug Administration (FDA) recently released guidance for the collection of blood … Continue Reading

Identifying Overpayments Under the ACA’s 60-Day Rule Creates Additional Uncertainty in Determining False Claims Act Liability

Under the Affordable Care Act (ACA), healthcare providers that receive an overpayment from Medicare or Medicaid are required to report and return the overpayment to the government within 60 days after the date on which the overpayment was identified (commonly referred to as the “60-day rule”). An overpayment retained after 60 days constitutes an “obligation” for purposes of potential False … Continue Reading

OIG Issues Favorable Opinion Giving Green Light To Health System’s Shuttle Service

The Office of Inspector General (OIG) recently issued another advisory opinion on free patient transportation (OIG Adv. Op. No. 15-13, dated October 21, 2015). In the opinion, the OIG addresses whether providing patients a free shuttle service between medical facilities operated by an integrated health system (the System) would be prohibited remuneration to beneficiaries under the Anti-Kickback Statute. … Continue Reading

Illinois Enacts Patient Notification Requirement for Observation Stays

Illinois joins a growing number of states to pass laws requiring that hospitals provide notice to patients who are placed under observation status. 210 ILCS 86/6.09b As with the recent federal NOTICE Act, the laws respond to patients not understanding the difference between observation in a hospital bed and inpatient admission. The Illinois law requires a hospital to notify … Continue Reading

Hospitals Required to Notify Medicare Beneficiaries of Observation Status

The NOTICE Act (Notice of Observation Treatment and Implication for Care Eligibility) has been signed into law as of August 6, 2015. The Act requires hospitals to provide oral and written notice to patients within 36 hours of being placed in observation care (or, upon discharge, if sooner). The notice must explain to patients, in plain language, that they have … Continue Reading

CMS Publishes Notice of Proposed Rule Making Regarding Stark Law Amendments and Seeks Comment on the Issue of Stark Acting as a Barrier to Healthcare Reform

In early July, the Centers for Medicare and Medicaid Services (CMS) published a notice of proposed rulemaking, amending the Physician Self-Referral Prohibitions, or Stark law. 80 Fed. Reg. 41,909-930 (July 15, 2015). The proposed rule introduces two exceptions to Stark. The first new exception, 42 C.F.R. §411.357(x), allows financial assistance to medical practices so they may be able to recruit … Continue Reading

LexBlog