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HIPAA Criminal Penalties – Defendant May Be Found Guilty without “Knowledge” That Acts Are Illegal
May 21, 2012 | Blog | By Daria Niewenhous
Individuals who access protected health information without authorization may be found guilty of a misdemeanor even if they lack knowledge that their actions are illegal.
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Abbott Labs to Pay $1.6 Billion to Settle Consumer Protection and Misbranding Claims
May 8, 2012 | Blog
Abbott Laboratories (Abbott), an Illinois company, will pay over $1.6 billion in penalties to the federal government and several states related to its alleged illegal promotion of the prescription drug Depakote for off-label uses, as announced by the settling parties on May 7, 2012.
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CMS, CCIO, and IRS Release Guidance Proposals on Employer Health Insurance Coverage
May 7, 2012 | Blog
The Centers for Medicare & Medicaid Services Center for Consumer Information and Insurance Oversight (CCIIO) and the Internal Revenue Service (IRS) recently released four important documents related to the implementation of the Affordable Care Act (ACA) that address employer-provided health insurance plan reporting requirements and the availability of premium tax credits to individuals and families.The Centers for Medicare & Medicaid Services Center for Consumer Information and Insurance Oversight (CCIIO) and the Internal Revenue Service (IRS) recently released four important documents related to the implementation of the Affordable Care Act (ACA) that address employer-provided health insurance plan reporting requirements and the availability of premium tax credits to individuals and families.
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Press Coverage Triggers HIPAA-Related Inquiry
May 7, 2012 | Blog | By Karen Lovitch
Most state and federal health care investigations are prompted by audits or claims brought by whistleblowers. But a recent newspaper article about a debt collection company’s tactics has prompted Congressional ire and potentially a federal investigation.
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Sunshine Act Implementation Delayed Until 2013
May 4, 2012 | Blog | By Brian Dunphy
With little fanfare, the Centers for Medicare & Medicaid Services (CMS) announced today on the CMS Blog that it is delaying data collection under the Sunshine Act until 2013.
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OIG Advisory Opinion 12-05 Approves Consumer Rewards Program
May 2, 2012 | Blog | By Karen Lovitch, Theresa Carnegie
In OIG Advisory Opinion 12-05, the OIG found that a consumer rewards program (the “Program”) offered by a supermarket chain with in-store and independent pharmacies (the “Requestor”) would not be subject to enforcement under the Anti-Kickback Statute (the “Kickback Statute”) or the beneficiary inducement prohibition found in the civil monetary penalties law (the “CMP Law”).
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Analysis of Health Insurer-Hospital Vertical Merger Submitted to ABA/AHLA Antitrust in Healthcare Conference
April 20, 2012 | Blog | By Karen Lovitch
Christi Braun and Farrah Short have submitted a paper for the 2012 ABA/AHLA Antitrust in Healthcare Conference in which they discuss the proper role of antitrust enforcement in achieving today’s health care reform goals in the context of hospital-health insurer vertical mergers.
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CMS To Pay Hospitals Over $3 Billion for CMS' Miscalculation
April 16, 2012 | Blog
Hospital chains Hospital Corporation of America (HCA) and Tenet Healthcare Corporation (Tenet) announced on April 12th that the Centers for Medicare & Medicaid Services (CMS) has admitted that it erroneously calculated the rural floor provision established by the Balanced Budget Act of 1997.
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CMS Selects 27 ACOs
April 13, 2012 | Blog | By Brian Dunphy
In another step toward implementation of Accountable Care Organizations (ACOs), on April 10, 2012, the Centers for Medicare & Medicaid Services (CMS) selected 27 ACOs in 18 states to participate in the Medicare Shared Savings Program (Shared Savings Program).
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CMS Issues Final Rule Impacting Medicare Advantage and Medicare Part D Programs for Contract Year 2013
April 13, 2012 | Blog | By Karen Lovitch
The Centers for Medicare & Medicaid Services (“CMS”) recently published final regulations implementing program and technical changes to the Medicare Advantage (“MA”) and Medicare Prescription Drug (“Part D”) benefit programs.
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ML Strategies Posts Weekly Health Care Reform Update on April 2, 2012
April 2, 2012 | Blog | By Daria Niewenhous
ML Strategies has posted its weekly Health Care Reform Update. This publication provides timely and concise information on implementation of the Affordable Care Act, and other state and federal administrative and legislative activities related to health care reform.
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DOJ's Strategies - FCPA and Health Care Fraud
March 31, 2012 | Blog
For insights into how Foreign Corrupt Practices Act (FCPA) enforcement is creeping into the pharmaceutical and medical device manufacturer arena, see this article, which I co-authored with Paul Pelletier, former principal deputy chief of the Criminal Division's Fraud Section at the Department of Justice (DOJ).
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HHS Issues Report to Congress on the Self-Referral Disclosure Protocol
March 28, 2012 | Blog | By Brian Dunphy
On March 23, 2012, the Department of Health and Human Services (HHS) issued its statutorily required report to Congress (Report) describing the implementation of the Medicare Physician Self-Referral Disclosure Protocol (SRDP) and the status of disclosures under the SRDP to date.
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HIPAA Omnibus Rule Expected Within 90 Days - Pending Review at OMB
March 27, 2012 | Blog | By Dianne Bourque
Officials from the Department of Health and Human Services Office for Civil Rights (OCR) announced March 26 that the long-awaited rule updating Health Insurance Portability and Accountability Act (HIPAA) regulations has been sent to the Office of Management and Budget (OMB).
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OIG Approves Wholly Owned Subsidiary GPO Arrangement
March 21, 2012 | Blog | By Karen Lovitch, Theresa Carnegie
In Advisory Opinion 12-01, the Office of Inspector General for the Department of Health and Human Services (OIG) analyzed a proposal from a nonprofit health system (the “System”) to form a group purchasing organization (the “Proposed GPO”) for the benefit of the System’s affiliates and subsidiaries.
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Client Alert - The False Claims Act: The Impact in 2012
March 20, 2012 | Blog | By Daria Niewenhous
Mintz Levin has issued a Client Alert: The False Claims Act: The Impact in 2012 - Part II in a Continuing Series on Health Care Enforcement.
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HHS OCR Announces First Settlement of a Self-Reported HIPAA Violation
March 15, 2012 | Blog | By Dianne Bourque
No one wants to be the first, especially not in this case. The Department of Health and Human Services' Office of Civil Rights (OCR) announced its first settlement with a covered entity stemming from a report submitted pursuant to the Health Information Technology for Economic and Clinical Health Act's (HITECH) Breach Notification Rule (the "Rule").
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New York Court Finds Private Right of Action Under State’s Prompt Pay Law
March 8, 2012 | Blog | By Daria Niewenhous
On February 22, 2012, a New York State Court held for the first time that a provider may bring a claim against a health insurer under the State’s prompt pay law (PPL).
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New FDA Research Consent Form Requirements – Effective Today
March 7, 2012 | Blog | By Daria Niewenhous, Dianne Bourque
Starting today, March 7, 2012, clinical research consent forms for certain FDA-regulated clinical trials must contain a specific statement advising participants that clinical trial information will be entered into the ClinicalTrials.gov database.
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ML Strategies Posts Weekly Health Care Reform Update on March 5, 2012
March 5, 2012 | Blog | By Daria Niewenhous
ML Strategies has posted its weekly Health Care Reform Update. This publication provides timely and concise information on implementation of the Affordable Care Act, and other state and federal administrative and legislative activities related to health care reform.
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