Health Care Law Blog
It is time for hospitals and physicians to start using electronic health records ("EHR"). It is particularly important if hospitals or physicians want to take advantage of the 2011 Medicare incentive payments, since important deadlines are quickly approaching.
The latest edition of the Foster Swift Health Care Law Newsletter has just been released. Topics include Electronic Health Records, Medicare Reimbursement for Resident Research and Hospital Community Needs Assessments. In order to whet your appetite, below is a brief summary of the articles:
All providers and suppliers that were enrolled with the Medicare program prior to March 25, 2011 will be asked to revalidate their enrollment information in the near future. According to a statement issued by the Department of Health and Human Services' Centers for Medicare and Medicaid Services ("CMS"), intermediaries will begin contacting providers and suppliers to do the following:
The 4th Circuit Court of Appeals has issued two opinions related to the Patient Protection and Affordable Care Act ("PPACA"), also commonly referred to as Health Care Reform. What is interesting in these two decisions is that the appellate court refrains from ruling on the constitutionality of PPACA. Instead, it does not even address the issue because it found adequate grounds to dismiss both cases based on lack of jurisdiction.
On August 24, the Michigan legislature passed two bills which are expected to be signed by Governor Snyder, which will be known as the "Health Insurance Claims Assessment Act". The Health Insurance Claims Assessment Act will assess a 1% health care claims tax on paid health insurance claims in Michigan. This tax will be paid by health insurers and replaces an existing 6% assessment on Medicaid health claims. The tax will be assessed for a period of two years, beginning January 1, 2012 and ending January 1, 2014.
The Department of Health and Human Services ("DHHS") is moving forward with its HIPAA auditing program, which will launch in late 2011 or in 2012. After the audit protocols have been created, they will be field-tested through approximately 20 audits. Once the field tests are completed, up to 150 on-site audits will take place through the end of 2012. It is not clear which types of entities will be selected for audit. It is also not yet clear whether the DHHS Office for Civil Rights ("OCR") will audit only covered entities, or whether business associates will be audited as well. In addition, the OCR has not yet determined whether or how it will publish its audit results. Given the significance of being subject to a HIPAA audit, organizations should take this time to review their policies and procedures for HIPAA privacy and security compliance. Moreover, with the newness of electronic health record ("EHR") systems, those with EHR will especially want to make sure that these systems are compliant. Please contact me at 517.371.8231 or 906.226.5501 if you would like assistance with any review.
The 11th Circuit Court of Appeals recently issued a decision declaring that the "individual mandate" provisions of the Patient Protection and Affordable Care Act ("PPACA") are unconstitutional. This decision directly conflicts with the decision issued by the 6th Circuit Court of Appeals earlier this summer.
In the race to the top, the 6th Circuit decision upholding the constitutionality of the Patient Protection and Affordable Care Act ("PPACA") is the first to come before the United States Supreme Court. In response to the 6th Circuit's adverse ruling against it (discussed here), the Thomas More Law Center, et. al., recently petitioned the Supreme Court for review.
The Petition specifically presents two questions for consideration by the Supreme Court:
The US Supreme Court recently delivered a victory to data miners and pharmaceutical manufacturers in a June 23, 2011 decision, which held that a Vermont statute was an unconstitutional restriction of free speech rights. In William Sorrell v IMS Health, Inc., 564 US --- (2011), the Court reviewed a Vermont statute that prohibited the use of prescriber-identifiable information (details of a physician's prescription practices) for marketing or promoting a prescription drug. The statute was intended to target the practice of "detailing" a pharmaceutical representative's use of a particular physician's prescribing history to tailor a sales pitch to that physician in an effort to persuade him or her to prescribe certain (high profit or brand name) drugs. Because various Circuit Courts of Appeal had reached opposite conclusions on the constitutionality of similar statutes, the United States Supreme Court agreed to hear the case.
The month of June has been flush with medical professionals heading to jail for Medicare fraud.
Most recently, a Miami-Dade county doctor, Dr. Rene de los Rios was given a lengthy 20 year sentence for his participation in a Medicare fraud scheme. Dr. de los Rios falsified hundreds of patient records to the tune of $46.2 million for HIV therapy. Many of his patients received kickbacks. While, Dr. del los Rios' attorney argued for a shorter sentence (given his client's 72-years of age), the U.S. District Judge refused and instead chastised Dr. del los Rios for violating his medical oath, stealing from the vulnerable government program, and disgracing himself.
