On June 27, 2012, the U.S. Senate passed (by a vote of 92-4) the Food and Drug Administration Safety and Innovation Act, a bill primarily designed to let the U.S. Food and Drug Administration (“FDA” or “Agency”) collect user fees from prescription drug and medical device manufacturers to help fund the Agency. The House of … Continue Reading
The decision we’ve all been waiting for is in — the U.S. Supreme Court has ruled that the statute commonly known as the individual insurance mandate (everyone must have minimum health insurance coverage or pay a penalty) is constitutional under Congress’ taxing power. Because the individual mandate was upheld, the rest of the Affordable Care Act (“PPACA”) has also survived. The … Continue Reading
The U.S. Supreme Court has completed announcing its decisions for today, and still no decision on PPACA (Department of Health and Human Servs. v. Florida (No.11-398) and National Federation of Independent Business v. Sebelius (No. 11-393)). The Court is sitting again on Thursday and will likely announce decisions in the remaining cases from this term … Continue Reading
Two workgroups that advise the Office of the National Coordinator for Health Information Technology seek input to identify ways in which Meaningful Use Stage 3 may advance the consistent delivery of high quality care in diverse care settings. The committees recently hosted a meeting of experts from health care delivery organizations, quality improvement organizations, industry, … Continue Reading
On June 18, the OIG published notice in the Federal Register advising that it is now soliciting information and recommendations for revising its provider self-disclosure protocol. [https://www.federalregister.gov/articles/2012/06/18/2012-14585/solicitation-of-information-and-recommendations-for-revising-oigs-provider-self-disclosure-protocol#p-13] The OIG’s self-disclosure protocol is a mechanism whereby providers may voluntarily disclose self-discovered evidence of potential violations of the Anti-Kickback Statute. Providers utilizing the protocol must disclose a … Continue Reading
It appears that the National Medicaid Audit Program hasn’t been worth the money it cost to run. According to published testimony released by the Government Accountability Office (GAO) today, only 4% of the 1,550 audits, though, resulted in refunds to the government of approximately $7.4 million. More than two-thirds of the audits found no overpayments. The remaining 27% … Continue Reading
As we get closer to receiving a decision from the U.S. Supreme Court on the constitutionality of PPACA and its individual insurance mandate, three major insurers have committed to continue some benefits that were required by PPACA. These announcements address some of the uncertainty being experienced by insureds who don’t know what will happen or how quickly changes … Continue Reading
The Affordable Care Act provides for nearly $30 million in grant funding for states to establish and strengthen Consumer Assistance Programs. States must apply for the grants and articulate how they will use the funding to assist their residents with problems and related questions regarding health insurance coverage. Consumer Assistance Programs provide assistance to state … Continue Reading
Last week, Farzad Mostashari, national coordinator for health information technology, announced that the final omnibus HIPAA rule governing the privacy, security, breach notification and enforcement rules, and the Genetic Information Non-Discrimination Act, should be issued by the end of summer. Mr. Mostashari made the announcement during the opening keynote of the Health Privacy Summit in … Continue Reading
The Chief Privacy Officer of the Office of the National Coordinator for Health Information Technology (“ONC”) recently released a new guide for providers and their staff to help understand HIPAA privacy and security when it comes to electronic health records (“EHRs”) and the meaningful use of EHRs. “Guide to Privacy and Security of Health Information” … Continue Reading
Yesterday, 45 commercial, federal and State insurers in seven markets today pledged to work with the Centers for Medicare & Medicaid Services (CMS) to improve access to quality health care at lower cost. Under the Comprehensive Primary Care initiative, CMS will pay primary care practices a care management fee, initially set at an average of … Continue Reading