Data collected during the coronavirus pandemic shows a disturbing trend of inequities in testing and treatment for COVID-19 among people of color. On July 20, 2020 the Department of Health and Human Services’ (HHS) Office for Civil Rights (OCR) issued a Bulletin for healthcare providers, hospitals, and state and local agencies that receive Federal financial assistance to address “Civil Rights … Continue Reading
Category Archives: Physicians
Subscribe to Physicians RSS FeedCARES Act Provider Relief Funds – The Requirements Are Taxing
The Internal Revenue Service (“IRS”) recently clarified that CARES Act Provider Relief Funds (“Relief Funds”) are considered taxable income for for-profit providers, including physician practices. This news comes as a surprise as many thought such funds would be considered “qualified disaster relief payments” and therefore not includible in gross income under Section 139 of the Internal Revenue Code (the “Code”). … Continue Reading
Novartis’ Simultaneous Settlements Break Records
Novartis Pharmaceuticals Corporation (Novartis) has started July with significant settlements, putting two different fraud and abuse matters behind them. In what has been identified as the largest settlement of an Anti-Kickback Statute lawsuit brought by a whistleblower pursuant to the False Claims Act’s (FCA) qui tam provision, Novartis, a pharmaceutical company based in East Hanover, New Jersey, has agreed to … Continue Reading
Limited Stark and Anti-Kickback Sanction Waivers Issued for Provider Payments During the Pandemic
The COVID-19 pandemic has led to urgent changes to how and where healthcare services are delivered. These changes could require expedited entry into new or modified arrangements for the delivery of essential healthcare goods and services, creating potential conflicts with the Stark Law (Section 1877 of the Social Security Act) and its regulations and potential Office of Inspector General (OIG) … Continue Reading
Accepting CARES Act Relief Funds for Health Care Providers? Tell Your Compliance Department
While the CARES Act signals relief for many healthcare providers, it is important to remember that there are strings attached and reasons for providers to involve their compliance departments in the use and tracking of the CARES Act relief funds.
The CARES Act promised, through the Public Health and Social Services Emergency Fund, to provide $100 billion in relief funds … Continue Reading
Some Things Never Change: EMTALA in the Time of COVID-19
Even in this time of crisis, nothing has changed about a hospital’s obligation to comply with the Emergency Medical Treatment and Labor Act (EMTALA). However, the Centers for Medicare and Medicaid Services (CMS) has issued guidance (available here) to, and some flexibility for, hospitals on how to provide care to the growing influx of patients during the COVID-19 pandemic.… Continue Reading
It’s More than PPE – Infection Control in Different Facility Settings
Facing unprecedented community spread of the 2019 Novel Coronavirus Disease (COVID-19), the Centers for Medicare and Medicaid Services (CMS) has provided additional guidance to a variety of health care providers that is designed to minimize further transmission of the disease. CMS responds to frequently asked questions related to the logistics for minimizing transmission of COVID-19 in various patient settings. Specifically, … Continue Reading
Taking Triage to Trial
The COVID 19 epidemic is bound to overwhelm available medical resources in the United States. Healthcare institutions and practitioners will be forced to make impossible life-or-death decisions regarding the allocation of manpower and supplies. They must also be ready to defend those decisions against a backlash of grief—and lawsuits—once the crisis has passed.
A defensible triage protocol must enable reasonable … Continue Reading
OCR COVID-19 Updates on HIPAA and Anti-Discrimination Laws
Hospitals will have a limited waiver of HIPAA sanctions and penalties during the COVID-19 outbreak as a result of a bulletin issued on March 16, 2020 by the U.S. Department of Health and Human Services. The Office of Civil Rights also issued a reminder that even during a medical emergency like the COVID-19 pandemic, all health care providers must comply … Continue Reading
Managing the Healthcare Workplace During the COVID-19 Outbreak
Healthcare providers have special concerns for their employees during the Coronavirus (COVID-19) global health pandemic.
Because COVID-19 spreads primarily as a result of close exposure to an infected person, healthcare employees are at higher risk of infection. While OSHA has a standard to protect employees from the spread of bloodborne pathogens, it currently has no standard for the spread of … Continue Reading
Direct Patient Billing Can Create Provider Liability in Florida
To bill or not to bill, that is the question. Or, more appropriately, who to bill and when to bill, that is the question. Providers who bill patients under the circumstances described below may face liability. What is a provider to do?
A patient was injured in the course of her employment in December 2013 and applied for workers’ compensation … Continue Reading
Florida Patient Brokering Act Amended – Does it Clarify or Create New Issues?
The Florida Legislature recently passed HB 369 (the Bill), which would tweak an important provision of the Florida Patient Brokering Act, Section 817.505 of the Florida Statutes (Patient Brokering Act). It seeks to clarify the exception to the Patient Brokering Act which incorporated by reference the criminal provisions of the federal Anti-Kickback Statute (42 U.S.C. S1320a-7b(b)) pertaining to illegal remuneration) … Continue Reading
FTC Prevails in Physician Merger Case Before the 8th Circuit
The 8th Circuit Court of Appeals recently handed the Federal Trade Commission another appellate victory in its efforts to curtail anticompetitive mergers in the healthcare industry, affirming the FTC’s earlier District Court victory in Federal Trade Commission v. Sanford Health. The decision follows a number of other recent FTC appellate victories in healthcare merger cases – in the … Continue Reading
Possible Changes to Stark Law in 2019
Last summer The Centers for Medicare and Medicaid Services (CMS) solicited input on potential amendments to the federal Physician Self-Referral Law (the Stark Law). CMS intends the amendments to eliminate obstacles to its stated goal of enhancing coordinated care and transitioning from volume-based to value-based payment systems. By the end of last summer, almost 400 stakeholders had provided feedback, including … Continue Reading
Florida Clinic License Exemptions Subject to Change
Holders of Florida healthcare clinic license exemptions take note. Exemption certificates, which currently bear no expiration date, will expire every two years if a bill recently passed by the Florida Legislature becomes law. Senate Bill 622 will require exemption holders to renew their clinic license exemption biennially.
The bill is silent as to treatment of existing certificate holders, but businesses … Continue Reading
Medicare Providers Face December 1 Deadline to Request Review of Medicare Payment Adjustments
Providers have just a couple more days to challenge Medicare’s proposed 2018 value modifier payment adjustments. On September 18, 2017, Medicare released quality reports and measures used to calculate quality-based payment adjustments affecting providers’ 2018 Medicare fees. Physicians, physicians assistants, nurse practitioners, clinical nurse specialists, and nurse anesthetists who believe such proposed payment adjustments are in error have until 8 … Continue Reading
The Treating Physician: Entitled to Expert Witness Fees at Trial?
When is a treating physician considered an expert witness and therefore entitled to expert witness fees when he testifies at trial? Apparently, the Florida District Courts of Appeal have formulated the typical lawyer response – it depends!… Continue Reading
“Sometimes Wrong, Never in Doubt” – A New Perspective?
Two recent studies of medical malpractice claims highlight how patient complaints may identify those surgeons at greater risk for complications, a significant decrease in paid medical malpractice claims since 1992, and the need for greater understanding of the causes of differences in claims experience across medical specialties.… 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 II: Physicians
In contemplating the ways in which physicians may be affected by the possible repeal of the Affordable Care Act (ACA)—and certain features of any legislation that may replace it—a good place to start is with the person selected by President Trump to be the Secretary of the Department of Health and Human Services (HHS) – Representative Tom Price of Georgia, … Continue Reading
DEA Tweaks, Walks Back Changes to Renewal Process
DEA recently revised an earlier announcement that would have eliminated the grace period for renewals of controlled substance registrations. After initially declaring that prescribers and other registrants would no longer be able to renew their expired registrations during a grace period, DEA announced it would instead continue allowing that practice – for now at least. As a result, registrants who … Continue Reading
Coming Soon: More Paperwork for Healthcare Providers
Employers may see an uptick in requests for accommodations of mental disabilities, and healthcare providers may be asked to fill out yet more paperwork, as a result of two new publications issued by the EEOC last week.… Continue Reading
HHS Publishes a New Rule to Protect Dialysis Patients From Being “Steered” into Private Coverage for the Benefit of Dialysis Centers
On implementing significant, new requirements for Medicare-certified dialysis facilities that make payment of premiums for individual health coverage, on December 14, 2016, the Department of Health and Human Services (HHS) published an Interim final rule with comment period. The regulations become effective 30 days after the date of publication – January 13, 2017, and comments regarding the interim must be … 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
