Health Law Gurus

Health Law Gurus

Health Law: News,
Commentary & Insights

September 22, 2014 – HIPAA Compliance Deadline for Business Associate Agreements Is Just Around the Corner

Posted in Business Associates, Compliance Issues, HIPAA, Regulations

All business associate agreements (“BAAs”) must be updated and compliant with current Health Insurance Accountability and Portability Act (“HIPAA”) regulations by September 22, 2014. Failure to meet this deadline could result in large penalties for covered entities and/or business associates if there is a breach of protected health information (“PHI”) or a government audit. If you have not already done so, act now to ensure that you meet this important deadline. Continue Reading

News from the Health Law Gurus™: Week of August 31, 2014

Posted in Fraud and Abuse, News from the Health Law Gurus, Privacy, Technology, Trends

News from the Health Law Gurus™ is a weekly summary of notable health law news from around the country with helpful links to related content. Check back every week for the latest health law news stories.

HealthCare.gov Has Been Hacked, but Your Personal Information Is Safe – HealthCare.gov was hacked in July of this year. Fortunately, according to recent reports, the hacker only breached a server for code testing, and personal information appears to be safe. The hacking only adds to the list of problems that the government has faced with the launch of HealthCare.gov, which has been well-known for technical difficulties during the first period of open enrollment. The hacking also highlights the need for health care companies and organizations to evaluate the security of their networks and servers as cybersecurity incidents continue to be a serious source of concern in the health care industry. Notably, Chinese hackers recently infiltrated a health system network, compromising the information of 4.5 million individuals. To read our previous blog post about this Chinese hacking incident, click here. To read a Wall Street Journal article by Danny Yadron about the hacking of HealthCare.gov, click here. Continue Reading

News from the Health Law Gurus™: Week of August 24, 2014

Posted in Affordable Care Act (ACA), Anti-Kickback Statute, Medicare, News from the Health Law Gurus, OIG Advisory Opinion, Trends

News from the Health Law Gurus™ is a weekly summary of notable health law news from around the country with helpful links to related content. Check back every week for the latest health law news stories.

CMS Bolsters Roster Before Next Health Insurance Marketplace Open Enrollment Period – The Department of Health and Human Services and the Centers for Medicare and Medicaid Services (“CMS”) have announced the addition of two new individuals to their team in anticipation of the next Health Insurance Marketplace open enrollment period, which begins this fall, to obtain health insurance coverage in 2015. According to the press release, Kevin Counihan and Lori Lodes, have been hired to help ensure successful enrollment. Mr. Counihan has been named the Marketplace CEO and Ms. Lodes is the new Director of Communications for CMS. Mr. Counihan previously served as the CEO for Connecticut’s successful Health Insurance Exchange and Ms. Lodes was the Senior Vice President for Campaigns and Strategies for the Center for American Progress Action Fund and the Center for American Progress. To read the full announcement, click here. Continue Reading

News from the Health Law Gurus™: Week of August 17, 2014

Posted in Affordable Care Act (ACA), Compliance Issues, False Claims Act, Fraud and Abuse, Health Insurance, HIPAA, News from the Health Law Gurus, Stark Law

News from the Health Law Gurus™ is a weekly summary of notable health law news from around the country with helpful links to related content. Check back every week for the latest health law news stories.

Chinese Hackers Infiltrate Health System Network Affecting 4.5 Million Individuals – Community Health Systems, Inc. (“CHS”) reported this week that the information of approximately 4.5 million individuals has been affected by a Chinese cyber-attack. CHS and its affiliates own and operate 206 hospitals in 29 states. CHS stated in a report filed with the Securities and Exchange Commission on Monday that the attackers, believed to be a group originating in China, “used highly sophisticated malware and technology to attack” its computer network. Read our full blog post here. Continue Reading

Chinese Hackers Infiltrate Health System Network – Information of 4.5 Million Individuals Stolen

Posted in Compliance Issues, HIPAA, Privacy

Community Health Systems, Inc. (“CHS”) reported yesterday that the information of approximately 4.5 million individuals has been affected by a Chinese cyber-attack. CHS and its affiliates own and operate 206 hospitals in 29 states.

CHS stated in a report filed with the Securities and Exchange Commission on Monday that the attackers, believed to be a group originating in China, “used highly sophisticated malware and technology to attack” its computer network. Continue Reading

News from the Health Law Gurus™: Week of August 3, 2014

Posted in Affordable Care Act (ACA), Compliance Issues, Fraud and Abuse, News from the Health Law Gurus, Technology, Trends

News from the Health Law Gurus™ is a weekly summary of notable health law news from around the country with helpful links to related content. Check back every week for the latest health law news stories.

ICD-10 Compliance Deadline Is Now October 1, 2015 – Health care providers, health plans, and health care clearinghouses (“Health Care Entities”) are required to comply with ICD-10 (which stands for the International Classification for Diseases, 10th Edition) on October 1, 2015, according to a new final rule (“Final Rule”) released by the U.S. Department of Health and Human Services (“HHS”). This means that Health Care Entities must be ready for ICD-10 on October 1, 2015 in order to receive reimbursement for claims. Health Care Entities are required to continue using ICD-9 through September 30, 2015. Read our full blog post here.  Continue Reading

ICD-10 Compliance Deadline Is Now October 1, 2015

Posted in Compliance Issues, Regulations, Technology

Health care providers, health plans, and health care clearinghouses (“Health Care Entities”) are required to comply with ICD-10 (which stands for the International Classification for Diseases, 10th Edition) on October 1, 2015, according to a new final rule (“Final Rule”) released by the U.S. Department of Health and Human Services (“HHS”). This means that Health Care Entities must be ready for ICD-10 on October 1, 2015 in order to receive reimbursement for claims.

The Final Rule officially changes the ICD-10 compliance date from October 1, 2014 to October 1, 2015 and requires Health Care Entities to continue using ICD-9 through September 30, 2015. This implementation delay is yet another delay in a lengthy transition process. The Centers for Medicare and Medicaid Services (“CMS”) stated in a press release that “[w]hile many providers, including physicians, hospitals, and health plans, have completed the necessary system changes to transition to ICD-10, the time offered by Congress and this [Final Rule] ensure all providers are ready.” Continue Reading

News from the Health Law Gurus™: Week of July 20th, 2014

Posted in Affordable Care Act (ACA), False Claims Act, Fraud and Abuse, News from the Health Law Gurus, Privacy

News from the Health Law Gurus™ is a weekly summary of notable health law news from around the country with helpful links to related content. Check back every week for the latest health law news stories.

Circuit Split on ACA Subsidies—On Tuesday, the Court of Appeals for the D.C. Circuit (“D.C. Circuit”) and the Court of Appeals for the Fourth Circuit (“Fourth Circuit”) came to different conclusions as to the legality of Affordable Care Act (“ACA”) subsidies in Halbig v. Burwell and King v. Burwell, respectively. In both cases, the challengers argued that Section 36B of the ACA, which creates subsidies for purchasing health insurance, only applies to health insurance plans purchased through a state-established health insurance exchange, and not a federally-created health insurance exchange.  The D.C. Circuit sided with the challengers and found that the subsidies did not apply to federal exchanges, while the Fourth Circuit felt that the Internal Revenue Service’s interpretation of Section 36B, that subsidies are available for plans purchased through both state and federal exchanges, was valid. Read our full blog post here. Continue Reading

A Tale of Two Circuits: D.C. Circuit, Fourth Circuit Split on ACA Subsidies

Posted in Affordable Care Act (ACA), Individual Mandate

It was the best of times for ACA subsidies, it was the worst of times for ACA subsidies. On Tuesday, the Court of Appeals for the D.C. Circuit (“D.C. Circuit”) and the Court of Appeals for the Fourth Circuit (“Fourth Circuit”) came to different conclusions as to the legality of Affordable Care Act (“ACA”) subsidies in Halbig v. Burwell and King v. Burwell, respectively. In both cases, the challengers argued that Section 36B of the ACA, which creates subsidies for purchasing health insurance, only applies to health insurance plans purchased through a state-established health insurance exchange, and not a federally-created health insurance exchange. The Internal Revenue Service (“IRS”) has interpreted Section 36B to allow those purchasing health insurance through both federal and state exchanges to qualify for subsidies in the form of tax credits. Continue Reading

News from the Health Law Gurus™: Week of July 13th, 2014

Posted in Affordable Care Act (ACA), False Claims Act, Fraud and Abuse, Legislation, News from the Health Law Gurus

News from the Health Law Gurus™ is a weekly summary of notable health law news from around the country with helpful links to related content. Check back every week for the latest health law news stories.

$1 Million Settlement Reached in $73 Million Overbilling FCA Suit—Florida-based Halifax Health (“Halifax”) has settled a False Claims Act (“FCA”) suit brought by whistleblower and former compliance officer Elin Baklid-Kunz for $1 million. In the suit, Baklid-Kunz alleged that between 2002 and 2013, Halifax admitted patients for unnecessary and expensive inpatient procedures resulting in overbilling of Medicare in the amount of $73 million dollars. This settlement comes after Halifax reached an $85 million settlement in March over allegations that it had improper financial relationships with referring physicians. The Department of Justice (“DOJ”) has until July 21, 2014 to approve of the settlement. Read a Modern Healthcare article on the settlement here.   Continue Reading