New York State Enforces Data Breach Notification Law

Posted in Healthcare Law, HIPAA, Privacy, and Data Security

Earlier this month, New York Attorney General Eric Schneiderman announced his state had entered into a settlement with CoPilot Provider Support Services, Inc. (CoPilot)—a settlement resulting from CoPilot’s violation of the data breach notification requirements of the New York General Business Law (GBL) that requires companies, among other things, to provide notice of a breach as soon as possible. Under the terms of the settlement, CoPilot, which operates a website physicians use to determine whether certain medications are covered by insurance, must pay a $130,000 fine, update its relevant policies and procedures to ensure compliance with New York’s consumer protection and data security laws, and train all of its officers, managers, and employees as to their duties in making certain CoPilot complies with the GBL and provides timely notice to any consumers affected by a data breach. Continue Reading

Senate Healthcare Bill Released for Public Review

Posted in Affordable Care Act and Other Healthcare Reform Legislation, Government Affairs, Licensure & Regulatory, Health Insurers & Managed Care Organizations, Healthcare Law, Healthcare Reform Legislation, Hospitals & Health Systems, Medicare & Medicaid

Just over four weeks after the Congressional Budget Office (CBO) released its score of the American Healthcare Act (AHCA), the bill passed by a narrow margin in the U.S. House of Representatives, the U.S. Senate released ‘The Better Care Reconciliation Act of 2017’. Upon initial review, we are providing a quick overview of this proposed legislation.  Continue Reading

Repeal of the Affordable Care Act Will Not Include Changes to Tax Exempt Hospitals’ 501(r) Charitable Care Obligations

Posted in Affordable Care Act and Other Healthcare Reform Legislation, Government Affairs, Licensure & Regulatory, Health Insurers & Managed Care Organizations, Healthcare Law, Healthcare Reform Legislation, Hospitals & Health Systems

While the Senate Budget Committee works to draft legislation to reconcile the American Health Care Act, the repeal and replace bill passed by the House, there is no expectation of a repeal of the charitable care obligations imposed on tax exempt hospitals under Section 501(r) of the Internal Revenue Code as part of the Affordable Care Act. Continue Reading

ERISA Exemption Upheld for Religious-Affiliated Hospitals

Posted in Healthcare Law, Hospitals & Health Systems, Tax Exempt

Hospitals that are “church-affiliated” may be breathing easier this week, following the U.S. Supreme Court’s decision on Monday that defined benefit qualified retirement plans (a/k/a pension plans) are not subject to the Employee Retirement Income Security Act (ERISA). The Supreme Court confirmed that ERISA does not require an exempt “church plan” to have actually been established by the church itself.  Rather, certain religious-affiliated healthcare organizations can establish the plans.  Continue Reading

“Sometimes Wrong, Never in Doubt” – A New Perspective?

Posted in Healthcare Law, Healthcare Litigation, Hospitals & Health Systems, Physicians

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

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

Posted in Affordable Care Act and Other Healthcare Reform Legislation, Government Affairs, Licensure & Regulatory, Health Insurers & Managed Care Organizations, Healthcare Law, Healthcare Reform Legislation, Hospitals & Health Systems, Medicare & Medicaid

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 insurance in the country is a larger question. Continue Reading

Global Ransomware Attack Makes Healthcare Organizations Wanna Cry

Posted in Electronic Health Records & Medical Records, HIPAA, Privacy, and Data Security, Hospitals & Health Systems, Physicians

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 fears that the number of affected computers could increase significantly when employees start the new work week and turn on their computers. To make matters worse, cybersecurity experts are warning organizations to be alert for new variants of the ransomware that may be released in the coming days. Continue Reading

The American Health Care Act: Now What Happens?

Posted in Affordable Care Act and Other Healthcare Reform Legislation, Government Affairs, Licensure & Regulatory, Health Insurers & Managed Care Organizations, Healthcare Law, Medicare & Medicaid

To great fanfare by both the leadership of the Republican caucus in the House of Representatives (the House) and President Trump, on May 4, 2017, the American Health Care Act (AHCA), the proposed successor/replacement to the Affordable Care Act (ACA), passed the House by a narrow vote of 217-213. Unsurprisingly, no member of the Democratic Party in the House voted for the bill, but what should have been an easy vote was a bit of a nail-biter, as 20 members of the Republican caucus voted against the legislation. While a victory, it is a slim margin. The question that has been bandied about over the last several days is simply, what happens next? Continue Reading

April Showers Bring More HIPAA Settlements

Posted in Electronic Health Records & Medical Records, Healthcare Law, HIPAA, Privacy, and Data Security

April proved to be a busy month for the U.S. Department of Health and Human Services Office for Civil Rights (OCR) under its newly appointed director, Roger Severino. OCR announced three settlements of potential HIPAA violations totaling nearly $3,000,000.00 in fines. The settling parties include a wireless health services provider, a federally-qualified health center (FQHC), and a pediatric specialty provider. The settlements indicate that last year’s trend of higher settlement amounts and more robust corrective action plans appears to be continuing. Continue Reading

Medicare Advantage 2018 Rate Announcement

Posted in Health Insurers & Managed Care Organizations, Medicare & Medicaid

The Centers for Medicare and Medicaid Services (CMS) announced its 2018 Medicare Advantage (MA) capitation rates, with an expected increase of .45 percent, slightly higher than proposed in the advance notice. CMS estimates that MA health plans will realize an increase in revenue of 2.95 percent, reflecting increases in coding acuity and risk adjustment payments. CMS emphasized that the policies behind the rate determination are to support flexibility and efficiency and to encourage innovative network arrangements. Almost one-third of Medicare beneficiaries, 18.3 million Americans, receive their Medicare benefits through a Medicare Advantage managed care health plan. Items of note include: Continue Reading

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