The HIPAA privacy rules have a number of disclosure exceptions, but those exceptions are only effective when state law also allows the disclosure. When there is no state-law exception, it is irrelevant that HIPAA would allow the disclosure. One such common situation involves crimes against patients. Continue reading
An interesting wrinkle in the development of False Claims Act cases has been the increase in whistleblowers who come from a position of trust. A recent example was an August 19, 2013 $26 million settlement with the Department of Justice by Shands Healthcare, a network of health care providers in Florida for which the complaint was recently unsealed. Continue reading
CMS indicated on its website in early November that it is extending the implementation period for another three months, until March 31, 2014. The website says that, “in general, CMS will not conduct post-payment patient status reviews for claims with dates of admission of October 1, 2013 thru March 31, 2014.” CMS also issued two new guidance documents on its website that describe selecting and reviewing hospital claims for patient status.
Written by: Emily Grey
The Center for Medicare and Medicaid Services (CMS) released what has become known as the “Two Midnight Rule” on August 2, 2013 in the Inpatient Prospective Payment System (IPPS). The Final Rule is available in the August 19, 2013 Federal Register.
Last week, in response to provider concerns and a letter from more than 100 members of Congress asking for postponement of the rule, CMS announced a 90 day implementation period beginning on October 1, 2013. Continue reading
In November, 2012, Louisiana health officials declined to create a state-run exchange, leaving it to the federal government to operate a marketplace for Louisiana residents. Only recently has any real clarity on the structure of the Louisiana Health Insurance Exchange been available for its October 1, 2013 opening date. Continue reading
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