Stacey L. Callaghan

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CMS Expands Reimbursement for Telehealth Services

Despite telehealth’s significant expansion over the past ten years, it has been plagued by a historically unstable regulatory and reimbursement landscape. While the reimbursement environment may still have room for improvement, the Centers for Medicare & Medicaid Services (CMS) Medicare physician fee schedule (PFS) Final Rule for CY 2018 (Final Rule) marked some significant victories … 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

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

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 … Continue Reading

Business Associates Beware! OCR Is Coming For You

Last week, the U.S. Department of Health and Human Services Office for Civil Rights (OCR) announced the first HIPAA settlement involving a business associate. Catholic Health Care Services of the Archdiocese of Philadelphia (CHCS), a nonprofit organization that provides management and information technology services to six wholly-owned skilled nursing facilities, agreed to pay $650,000 and enter … 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. … 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 … Continue Reading

OCR Issues New Guidance on “Reasonable and Cost-Based” Fees Associated with Medical Record Copying and Access

On February 25, 2016, the Office of Civil Rights (OCR) released a set of FAQs directed at healthcare providers and plans that are required to comply with the HIPAA Privacy Rule (the Privacy Rule). The guidance emphasizes that any fees charged for access to or copies of patient information must be “reasonable and cost-based” and … Continue Reading

Divestiture of St. Luke’s Acquisition Upheld Despite Transaction’s “Laudable” Goals

On February 10, 2015, the Federal Trade Commission (FTC) achieved a historic victory when a U.S. Court of Appeals ruled that a hospital’s acquisition of a physician’s group – the transaction challenged by the FTC – ran afoul of federal antitrust laws, despite the likelihood that the acquisition would result in greater efficiencies and quality … Continue Reading

HHS Announces First Timeline For Medicare Pay Reforms

On Monday, January 26, 2015, the Department of Health and Human Services (“HHS”) announced a timeline for moving physicians and hospitals into new payment systems and tying Medicare reimbursements to quality of care. This will affect hundreds of billions of dollars in Medicare payments (the goals apply to Medicare Parts A and B, which paid … Continue Reading
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