Category Archives: Physicians

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OIG Now Targeting Physician Compensation Arrangements

In a Fraud Alert issued on June 9, 2015, the U.S. Department of Health and Human Services Office of Inspector General (OIG) notified the healthcare community that physician compensation arrangements are on the OIG’s radar screen. While many physician compensation arrangements may be legitimate, the OIG has noted that “a compensation arrangement may violate the anti-kickback statute if even one … 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 of care. This decision marks … Continue Reading

CMS Announces Enforcement of EHR Payment Adjustments in 2015

On December 17, 2014, the Centers for Medicare and Medicaid Services (“CMS”) announced that there would be reductions in Medicare reimbursement for health care providers who do not meet the CMS electronic health record (“EHR”) incentive program’s meaningful use requirements. This announcement comes in the wake of CMS’ decision in October to extend the hardship exception deadline – an exception … Continue Reading

Reimbursement Changes, Shift to Consumerism Discussed at Akerman Healthcare Briefing

Changing reimbursement models and a shift to consumerism were two of the hot topics discussed at Akerman LLP’s recent Healthcare Briefing event titled “Financial and Corporate Implications of the Affordable Care Act: A Look at the Past, Present, and Future”. Health care and financial industry leaders gathered Friday, November 21 in Tampa for the interactive discussion. Panelists leading the discussion … Continue Reading

Talk Amongst Yourselves: HIPAA Does Not Preempt Florida Med Mal Presuit Authorization Law

A federal appellate court recently concluded that the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) does not preempt a Florida law that requires aggrieved patients to authorize the release of their protected health information as a presuit condition to suing a medical provider for negligence. See Murphy v. Dulay (11th Cir. Oct. 10, 2014) (opinion available here).… Continue Reading

CMS launches database of manufacturer and GPO payments to physicians

The Affordable Care Act contains a provision known as the Physician Payments Sunshine Act, which requires the Centers for Medicare and Medicaid Services (CMS) to establish a national databank containing information on the financial relationships between physicians (which includes dentists, chiropractors, and other physician specialties) and teaching hospitals, applicable manufacturers, and group purchasing organizations (GPOs). CMS launched its Open Continue Reading

Florida Board of Medicine Clarifies That Common Cardiac Procedures Can Be Performed In Office Surgical Setting.

The Florida Board of Medicine recently amended its office surgery rules to clarify that many common cardiac procedures already being performed in office surgical settings around the state may, in fact, be performed legally in those settings. Rule 64B8-9.009, Fla. Admin. Code, sets forth the standard of care for office surgery. The rule previously defined office surgery, in part, as … Continue Reading

Physicians and Photography Don’t Mix

A gynecologist who secretly photographed and videotaped women’s bodies in the examining room will cost one of the world’s leading medical institutions $190 million.  In a damaging blow to its reputation, Johns Hopkins Hospital has agreed to a settlement with more than 8,000 patients of Dr. Nikita Levy, who wore a pen-like camera around his neck to secretly record videos … Continue Reading

New OIG Special Fraud Alert Aimed at Laboratory Payments to Referring Physicians

On June 25, 2014, the U.S. Department of Health and Human Services Office of Inspector General (OIG) issued a Special Fraud Alert entitled “Laboratory Payments to Referring Physicians.” While the Alert breaks no new ground (see, e.g., its 1994 Special Fraud Alert), it demonstrates the OIG’s continuing concerns about clinical laboratories’ offering inducements to referring physicians.

The … Continue Reading

Patient Records: Increasing Exposure for Privacy Breaches

Healthcare providers and businesses that store or process protected health information (“PHI”) face increased scrutiny and significant fines for data privacy breaches and security lapses in the coming months. In the past 12 months, the U.S. Department for Health and Human Services Office for Civil Rights (“OCR”) has recovered more than $10 million in fines for alleged violations of HIPAA. … Continue Reading

HHS Proposes Extension of Deadline for EHR Compliance

According to the federal government, over 370,000 providers have participated in the Medicare and Medicaid Electronic Health Record (“EHR”) incentive program since its inception in 2011. However, providers nationwide continue to grapple with the challenges of complying with federal EHR requirements, and many such providers have voiced their displeasure to the federal government regarding the tight compliance timeframes. On Tuesday, … Continue Reading

Florida Board of Pharmacy Clarifies that Pharmacies Can’t Compound Sterile Human Drugs for “Office Use”

The Florida Board of Pharmacy rules allow pharmacies to engage in office-use compounding. Rule 64B16-27.700, FAC. This allows pharmacies to compound drugs for physicians to use in treating their patients in the office without writing a patient-specific prescription. It does not allow the physician to dispense the office-use drugs to their patients (i.e. give the patient a supply to take … Continue Reading

The Downside to Sharing – Two Hospitals to Pay Largest HIPAA Fine Yet

On May 7, 2014, the U.S. Department of Health and Human Services Office for Civil Rights  (“OCR”) announced the largest settlement to date under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”).  New York and Presbyterian Hospital (“NYP”) and Columbia University (“Columbia”) agreed to pay $4.8 million and enter into resolution agreements as the result of a breach … Continue Reading

Florida Says Can Do To Medical Cannabis

In the waning days of the 2014 legislative session, the Florida Legislature passed the Compassionate Medical Cannabis Act of 2014.  It is a very limited medical marijuana bill with very strict restrictions and conditions on use.  The bill allows access to only low-THC (tetrahydrocannabinol) cannabis (so-called “Charlotte’s Web”) for persons with cancer or another condition that produces seizures or … Continue Reading

Coming Fall 2014: HHS Launches Permanent Audit Program

Beginning in the Fall of 2014, a substantial number of covered entities and business associates will receive a notification and data request from the Health and Human Services’ (HHS) Office for Civil Rights (OCR).  According to Rachel Seeger, an OCR spokeswoman, “we hope to audit 350 covered entities and 50 business associates in this first go-around…Selected entities will receive notification … Continue Reading

The Government is Here to Help: HHS Releases HIPAA Security Risk Assessment Tool for Small Providers

The U.S. Department of Health and Human Services (“HHS”) has just released a new security risk assessment (“SRA”) tool to assist small and medium sized health care practices (one to ten providers) conduct a HIPAA risk assessment of their organization.

The HIPAA Security Rule requires that all health care organizations that are HIPAA covered entities or business associates must conduct … Continue Reading

Florida Department of Health Adopts New Telemedicine Rule: Florida Legislature Considers Changing the Law

While the Florida Department of Health (DOH) adopted a new telemedicine rule on March 12, 2014 [Rule 64B8-9.0141 and Rule 64B15-14.0081 of the Florida Administrative Code], several bills on the same subject are under consideration by the Florida Legislature. [See, SB 1646, SB 0070, HB 751, and HB 0167]  At the same time, the Federation … Continue Reading

Halifax Health and Government Settle False Claims Act Claims for $85 Million, But Case is Not Over

On March 10, 2014, Halifax Hospital Medical Center and Halifax Staffing, Inc. (collectively, “Halifax”) entered into a settlement agreement and a corporate integrity agreement (“CIA”) to resolve claims brought under the False Claims Act (“FCA”), alleging Halifax entered into improper incentive compensation arrangements with certain physicians in exchange for Medicare referrals. Halifax agreed to, among other things, pay $85 million … Continue Reading

California Supreme Court Expands Protections to Whistle-Blowers and Weakens Hospital Peer Review Systems

The recent decision by the California Supreme Court in Fahlen v. Sutter Central Valley Hospitals, No. S205568 , 2014 WL 655995 (Cal. 2014) may significantly weaken the efficacy of hospital peer review proceedings in California and may have implications for hospitals in other states. The court held that a physician is not required to exhaust peer review proceedings before … Continue Reading

Thought Leaders: These are “Turbulent,” “Transitional” Times in Healthcare

The phrase “the only constant is change itself” has rarely been so true across an entire industry. The U.S. healthcare sector is having to adjust to rapidly changing times. That whirlwind of change was discussed by industry leaders at Akerman’s recent panel event titled “Healthcare Issues for 2014: What Can You Expect?”

Panelists included Karen Zeiler, Senior Vice President of … Continue Reading

New Privacy Rule Gives Patients Right to Access Lab Test Reports

On February 6, 2014, the Centers for Medicare and Medicaid Services (CMS) and the U.S. Department of Health and Human Services Office for Civil Rights (HHS OCR) issued a final rule amending the Clinical Laboratory Improvement Amendments of 1988 (CLIA) and the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule to provide individuals the right to access … Continue Reading

HHS Gives a Thumbs Down for Stolen Thumb Drive

On December 26, 2013, the U.S. Department of Health and Human Services Office for Civil Rights (HHS) announced that it had reached an agreement with a Northeastern dermatology practice to settle potential HIPAA violations arising from a 2011 theft of an unencrypted thumb drive containing patient information. This is HHS’ first settlement with a covered entity arising from the failure … Continue Reading

“Meaningful” Errors Require Hospital System to Refund $31M

In what is reported to be the largest repayment to date involving “meaningful use” incentive payments, Naples, Florida-based Health Management Associates, Inc. (“HMA”), with 71 inpatient facilities in 15 states, including Florida, recently voluntarily notified the Centers for Medicare and Medicaid Services (“CMS”) that it erroneously certified its electronic health record (“EHR”) technology in the amount of $31 million dollars. … Continue Reading

PODs Continue to Attract Scrutiny from OIG and Congress

In the wake of a recent U.S. Department of Health and Human Services Office of Inspector General (“OIG”) investigation, physicians with ownership interests in medical device distributorships and hospitals should prepare for an uptick in the scrutiny of physician-owned distributorships (“PODs”). The OIG investigation generated a report, Physician-Owned Distributors of Spinal Devices: Overview of Prevalence and Utilization and follows the … Continue Reading

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