Recent False Claims Act Settlements Based on Hospital-Physician Compensation Arrangements

During the fall of 2015, the Department of Justice (DOJ) issued several press releases announcing large False Claims Act settlements based on alleged Stark Law violations related to hospital-physician compensation arrangements.  The following are three recent False Claims Act settlements involving allegations related to excessive and improper compensation arrangements between hospitals and physicians: Continue reading

HIPAA Amendment Purports to Strengthen the National Instant Criminal Background Check System (NICS) – Part II

Covered entities evaluating the impact of this HIPAA amendment should take note that the use or disclosure authorized by this amendment is PERMISSIVE, not mandatory.  The language of the rule states the covered entity “may” use or disclose PHI for purposes of reporting to the NICS the identity of an individual who is prohibited from possessing a firearm under 18 USC 922(g)(4).  The covered entity is not required to do so.   Therefore, if a covered entity isn’t sure whether they are allowed by this recent amendment to make a disclosure to the NICS, the normal compliance strategy would require careful consideration. Continue reading

HIPAA Amendment Purports to Strengthen the National Instant Criminal Background Check System (NICS) – Part I

The Department of Health and Human Services issued  a final rule modifying HIPAA.  The modification expressly permits certain limited “covered entities” to disclose to the NICS the identities of individuals who are subject to a Federal “mental health prohibitor” that disqualifies them from shipping, transporting, possessing, or receiving a firearm.  The scope of the amendment is narrow in that it authorizes the disclosure of “only the limited demographic and certain other information needed for purposes of reporting to the National Instant Criminal Background Check System” and specifically prohibits the disclosure of diagnostic or clinical information.  Further, very few covered entities will be impacted by this amendment.  The amendment authorizes the limited disclosure only if the covered entity is “a State agency or other entity that is, or contains an entity that is: (A) An entity designated by the State to report, or which collects information for purposes of reporting, on behalf of the State, to the National Instant Criminal Background Check System; or (B) A court, board, commission, or other lawful authority that makes the commitment or adjudication that causes an individual to become subject to 18 U.S.C. 922(g)(4).”

The Final Rule is available for review at  https://federalregister.gov/a/2015-33181.

Written by: Jacob Simpson

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Final 2016 Medicare Physician Fee Schedule Released

CMS released on October 30th the final Medicare Physician Fee Schedule for 2016, which contains several payment changes related to physicians services, and a large section finalizing several changes and clarifications to the Stark Law. It will be in the November 16th Federal Register.

Written by: Clay J. Countryman

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New Telemedicine Rules Issued By LSBME

The Louisiana State Board of Medical Examiners has amended its rules governing the use of telemedicine as it relates to patients who are located in Louisiana.  Among other things, the rules require a face-to-face patient encounter before a prescription may be issued by a physician via electronic means and outlines physician prerequisite conditions and disclosures that must occur prior to the use of telemedicine to provide medical services.  For more information, visit this month’s issue of the Louisiana Register:  http://www.doa.la.gov/Pages/osr/reg/regs2015.aspx.

Written by: Traci S. Thompson