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Showing 44 posts from 2012.

Most Favored Nation Order Released by Michigan Insurance Commissioner

favored nation orderIn what appears to be a strong response to the most favored nation ("MFN")-related lawsuits filed against Blue Cross Blue Shield of Michigan by the U.S. Department of Justice and Aetna, the Commissioner of the Michigan Office of Financial and Insurance Regulation (“OFIR”) issued an Order dated July 18, 2012. The Order prohibits insurers, HMOs, and Blue Cross Blue Shield of Michigan from either using or enforcing MFN clauses in their provider contracts unless the MFN clause has been filed with and approved by the OFIR Commissioner.  This prohibition takes effect February 1, 2013.  To read the Order, see the Order posted on the Department of Licensing and Regulatory Affairs webpage.

Categories: Billing/Payment, Hospitals, Insurance

Newly Released Audit Protocol Serves as Guidance for Compliance Programs

Newly Released Audit Protocol Serves as Guidance for Compliance ProgramsThe Health Information Technology for Economic and Clinical Health Act ("HITECH Act"), passed in 2009, imposed new requirements on health care providers (among others) related to the privacy and security of Protected Health Information ("PHI").  Included in the HITECH Act's requirements was a mandate that the Department of Health and Human Services’ ("HHS") Office for Civil Rights ("OCR") conduct audits to analyze the processes, controls and policies of certain covered entities.  The pilot program for such audits began in 2011 and will conclude in December, 2012. Read More ›

Categories: Compliance, HIPAA, HITECH Act, Hospitals, Physicians, Regulatory

Foster Swift Attorney Interviewed on the Supreme Court's Health Care Reform Decision and its Impact

health care reform decisionFoster Swift health care law attorney, Johanna Novak, was recently interviewed on Michigan Business Network radio concerning the United States Supreme Court's long-anticipated decision on the Patient Protection and Affordable Care Act (the "Act").  The interview aired on July 6, 2012, and was separated into two parts.  Podcasts for both parts of Johanna's interview can be accessed here. Read More ›

Categories: Employment, Health Care Reform, Regulatory

Breaking News: US Supreme Court Upholds Health Care Reform

Today, the United States Supreme Court released its highly anticipated opinion regarding the constitutional challenges to the Patient Protection and Affordable Care Act (the "Act"). The Court ultimately concluded that the Act was constitutional, but it did not grant a complete victory to the government.  The Court also held that the federal government may not withhold all Medicaid funds from States that fail to comply with the expansion of Medicaid provisions of the Act.  Instead, the federal government may only withhold new Medicaid funds from States that do not comply. Read More ›

Categories: Employment, Health Care Reform, Health Insurance Exchange, Insurance

Precautions of Prescribing Controlled Substances for Pain

Back PainIn response to growing concerns about prescription drug abuse, there has been a significant increase in investigative and enforcement activities by state licensing authorities as well as local, state and federal law enforcement. We have been contacted by physicians who want to care for patients with chronic or intractable pain but are concerned about the consequences to their licenses and practices that might result if investigators question their decision to prescribe controlled substances.  Given the current environment, it is a good idea for physicians to refresh themselves on the legal requirements for effective pain management. Read More ›

Categories: Hospitals, Physicians, Regulatory

Medicare Provider Enrollment: Revalidation Required

Health care reform law requires that providers who enrolled in Medicare prior to March 25, 2011, submit enrollment revalidation information upon request by the Centers for Medicare and Medicaid Services ("CMS") or its contractors.  Any provider that fails to submit the requested revalidation information within 60 days of receiving such a request risks interruption or deactivation of Medicare billing privileges.  Revalidation for all providers who enrolled in Medicare prior to the above date will occur between now and March of 2015 on a steady basis.  Providers can check the lists provided at CMS's website to determine if they were already sent a revalidation notice that was perhaps overlooked in the mail.

Categories: Hospitals, Medicare/Medicaid, Physicians

Michigan State University’s Health Insurance Mandate May Constrain Tuition Increases

health insurance mandateMichigan State University (“MSU”) currently requires that uninsured students obtain health insurance as part of its fee structure.  This requirement impacts approximately 14 percent of students. While this requirement is aligned with the Patient Protection and Affordable Care Act’s (“PPACA”) individual mandate, the requirement may negatively impact MSU’s ability to raise tuition. Read More ›

Categories: Insurance

Michigan's Integrated Care Proposal for Individuals Eligible for both Medicare and Medicaid

On April 26, 2012, the State of Michigan submitted its Integrated Care Proposal (Pilot Program) to the Centers for Medicare and Medicaid Services (CMS), for review and approval.  The Pilot Program is Michigan’s plan to jointly manage the care of approximately 200,000 residents who are eligible for both Medicare and Medicaid.  The Pilot Program submitted to CMS is not yet available on the Internet for public review.  However, the Department of Community Health has prepared a list of FAQs about the Program on its website. Read More ›

Categories: Insurance, Medicare/Medicaid

Health Care Employers Not Required to Post NLRB Notice Until Further Decision from the Courts

health care employersPreviously, the Foster Swift Health Care Law Blog notified you of an NLRB requirement for employers to display notices about employees' rights to organize a union.  The notice requirement was delayed, and employers were not required to post the notice until April 30, 2012.  On April 17, 2012, the United States Court of Appeals for the District of Columbia granted an emergency motion for injunction pending appeal and for expedited consideration related to the notice requirement.  This was discussed in Foster Swift’s recent Employment, Labor & Benefits E-News.  In particular, it is important to note that this court's decision means that employers are not required to post the notice until the court rules on the NLRB's authority to promulgate such a requirement.  Oral arguments on this issue are expected to occur in September, 2012.  Foster Swift's Employment, Labor & Benefits E-News and Health Care Law Blog will keep you posted on this issue. Read More ›

Categories: Employment, Labor Relations

Recommendation: Deregulation of 18 Occupations and Elimination of 9 Occupational Boards

On April 16, 2012, the Office of Regulatory Reinvention (“ORR”) issued a report to Governor Snyder proposing the deregulation of 18 occupations and the elimination of 9 occupational boards.  Of particular interest to Michigan health care providers are the recommendations for deregulation of dieticians and nutritionists; ocularists; respiratory care providers; and speech pathologists.  The report also recommended elimination of the following, health-care relevant occupational boards: Board of Dietetics and Nutrition, Board of Occupational Therapy, Board of Respiratory Care, Board of Speech Language Pathology, and Osteopathic Medicine Advisory Board. Read More ›

Categories: Licensing, Regulatory

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Best Lawyers® 2021

Congratulations to the attorneys of the Health Care practice group at Foster Swift Collins & Smith, PC for their inclusion in the Best Lawyers in America 2021 edition. Firm-wide, 44 lawyers were listed. Best Lawyers lists are compiled based on an exhaustive peer-review evaluation and as lawyers are not required or allowed to pay a fee to be listed; inclusion in Best Lawyers is considered a singular honor. Health Care practice group members listed in Best Lawyers are as follows:

To see the full list of Foster Swift attorneys listed in Best Lawyers 2021, click here.