Category Archives: Health Information

Louisiana Governor Signs Legislation Banning Common Abortion Procedure

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On June 1, 2016, Gov. John Bel Edwards signed a bill into law that bans the second-trimester abortion procedure known as “dilation and evacuation.”  This makes Louisiana the sixth state to prohibit this abortion method.  Under the new law, called the “Unborn Child Protection from Dismemberment Abortion Act,” the procedure will only be allowed if necessary to prevent “serious health risk” to the mother.  The law takes effect on August 1, 2016.   Only the performing physician will be legally responsible and subject to penalties for violations of the ban.  The penalties could include loss of license to practice medicine and the possibility of a fine up to $1,000 and a prison sentence of up to two years.

It is unclear whether this law will stand up to a legal challenge.  A similar law was blocked by state courts in Kansas and Oklahoma as violating the state Bill of Rights and the Due Process Clause of the Fourteenth Amendment of the U.S. Constitution.

See full text of the Unborn Child Protection from Dismemberment Abortion Act here.

Written by: Catherine Moore

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Enrollment Begins for Louisiana’s Medicaid Expansion

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Beginning June 1, 2016, Louisiana residents with a household income below 138 percent of the federal poverty level will be eligible to obtain healthcare coverage through the state’s Medicaid program. On January 12, 2016, Gov. John Bel Edwards signed an executive order to expand the Medicaid program, making Louisiana the 31st state to extend Medicaid.

The U.S. Department of Health & Human Services also approved a new approach to Medicaid enrollment that will allow Louisiana to use information from the Supplemental Nutrition Assistance Program (SNAP) to determine eligibility and enroll individuals in Medicaid.  Louisiana is the first state to be approved to use this enrollment strategy through the use of a state plan amendment.

Quick Facts:

  • Enrollment began on June 1
  • Coverage will be effective July 1
  • The State of Louisiana estimates that 375,000 new adults will enroll in coverage, with about 105,000 people already enrolled in SNAP identified as likely eligible for coverage.
  • Through 2016, the coverage for newly enrolled adults of up to 138% of the federal poverty line is completely funded with federal money. However, federal funding rates will decline beginning in 2017 (Federal funding rates will not fall below 90% of costs). [1]

[1] U.S. Department of Health & Human Services, HHS Secretary Sylvia M. Burwell Applauds Louisiana Medicaid Expansion Under the Affordable Care Act, (May 31, 2016).

Written by: Catherine Moore

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Physician Practice and Hospital Pay $750,000 and $1.5 Million for Failure to Have HIPAA Business Associate Agreements

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The Office for Civil Rights (OCR) recently announced two separate settlements with a hospital and a physician practice that highlight the importance of having HIPAA business associate agreements. Each of these HIPAA settlements were based on the failure to have a HIPAA business associate agreement in place with a third party that a hospital and a physician practice had disclosed patient’s healthcare information to perform certain administrative services. In each case, the third party recipients of patient electronic healthcare information committed or contributed to a breach under the HIPAA Privacy Rule. Continue reading →

Supreme Court Urged to Reject Far Reaching “Implied Certification” Theory Under the False Claims Act

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On April 19, 2016, the United States Supreme Court heard oral argument in Universal Health Services, Inc. vs. United States and Massachusetts ex. rel. Escobar. In Escobar, the Court will decide for the first time whether to embrace the theory of “implied certification” under the Federal False Claims Act (“FCA”), 31 U.S.C. §§3729-3733. Under that theory, a health services provider that requests payment from the Government for providing services while knowing, but not disclosing, that the services failed to meet requirements that were material to payment is deemed to have presented a false or fraudulent claim under the FCA. In other words, the theory states that the provider impliedly certifies that the billed for services meet the applicable requirements merely by submitting the claim for payment. Most Federal circuits which have considered the theory have adopted it in one form or another. Continue reading →

OCR Settlement with Physician Group Highlights Need For HIPAA Business Associate Agreements

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This week, the OCR announced another HIPAA settlement based on a provider’s failure to have a Business Associate Agreement in place before disclosing PHI to a third party business vendor.

OCR had initiated an investigation of Raleigh Orthopaedic Clinic, P.A. of North Carolina following receipt of a breach report which revealed a release of protected health information (PHI) without first having a business associate agreement (BAA) in place. Continue reading →