Day Pitney’s Healthcare Law Blog provides regular updates on issues affecting all aspects of the healthcare industry. In this era of ever-increasing regulation, we monitor healthcare news and developments from all federal and state agencies, as well as significant court decisions and public policy initiatives. We cut through the jargon and give our clients and other readers what they need to know in a concise, no-nonsense style to save them time while helping them stay informed.

Day Pitney LLP

About the Blog
Healthcare Law Blog Contacts

Practice Groups

Healthcare Law

Additional Day Pitney Blogs

The Venture Law Desk

Topics

Accountable Care Organizations
Affordable Care Act
Antitrust
Electronic Health Records
Employer/Employee Matters
FDA
Fraud and Abuse
HIPAA and the HITECH Act
Home Healthcare
Hospitals and Institutions
Legislation and Public Policy
Life Sciences
Litigation
Medical Devices
Medical Loss Ratio
Medicare and Medicaid
Mental Health
Pharmaceuticals
Privacy and Data Protection
Private Insurers
Reimbursement Matters
State Matters
Tax Matters/IRS
UK Matters
White Collar

Follow our blog posts on Twitter @daypitneyhealth, add this blog to your RSS feed (click here to read more about RSS), or put your e-mail address in the box below and hit GO to receive e-mail updates about recent blog entries, news alerts, invitations and other information related to Day Pitney’s Healthcare Practices.

Support Grows for Stark Law Modification or Repeal

Date: July 20, 2018 | Posted: Eric D. Fader | Topics: Fraud and Abuse; Legislation and Public Policy; Medicare and Medicaid; Reimbursement Matters

There has been a recent groundswell of support for modifying or eliminating the federal physician self-referral law, commonly known as the Stark Law. Last month’s Request for Information by the Centers for Medicare & Medicaid Services (CMS), seeking public comment, was the most prominent example. However, the wave of changes and proposed changes began slowly picking up steam a few years ago, with some changes to Stark going into effect on January 1, 2016.

Private Lawsuit Under HIPAA Dismissed

Date: July 19, 2018 | Posted: Eric D. Fader | Topics: Electronic Health Records; HIPAA and the HITECH Act; Legislation and Public Policy; Litigation; Privacy and Data Protection; State Matters

A recent federal court lawsuit by a private individual accusing Laboratory Corporation of America (LabCorp) of violating the Health Insurance Portability and Accountability Act was dismissed, confirming the well-established premise that HIPAA does not establish a private right of action for violations. This result must be distinguished from recent cases brought under various states’ laws in which HIPAA was deemed to establish a general standard of care for healthcare providers.

Physicians and Teaching Hospitals Received $8.4 Billion in Payments in 2017

Date: July 06, 2018 | Posted: Erin Healy | Topics: Affordable Care Act; Fraud and Abuse; Legislation and Public Policy; Life Sciences; Medical Devices; Medicare and Medicaid; Pharmaceuticals

On June 29, the Center for Medicare & Medicaid Services (CMS) published data summarizing payments made by drug and medical device companies to physicians and teaching hospitals during the 2017 Open Payments program year. Payments disclosed through the Open Payments program are represented in three categories: (i) research payments, which includes payments and transfers of value made in connection with a formal research agreement, (ii) physician ownership, which includes information about ownership or investment interests physicians or their immediate family members have in the reporting entities, and (iii) general payments, which includes payments or transfers of value that are not in connection with a research agreement or protocol.

Confidential Documents Suggest Horizon Misled Public on How it Picked Hospitals for OMNIA Program

Date: June 29, 2018 | Posted: Day Pitney | Topics: Hospitals and Institutions; Litigation; Private Insurers; State Matters

A June 27 article in The Star-Ledger and on NJ.com, "Confidential documents suggest Horizon misled public on how it picked hospitals for OMNIA program," discussed confidential reports and related documents that have been obtained in connection with a lawsuit brought by three New Jersey-based hospitals against Horizon Blue Cross Blue Shield of New Jersey. Day Pitney’s Mike Furey was quoted in the article.

Annual Health Care Fraud Takedown Is Biggest Ever

Date: June 28, 2018 | Posted: Eric D. Fader | Topics: Fraud and Abuse; Home Healthcare; Litigation; Medicare and Medicaid; Pharmaceuticals; Private Insurers; Reimbursement Matters; White Collar

On June 28, the U.S. Department of Justice (DOJ) and Department of Health and Human Services Office of Inspector General (OIG) announced their annual nationwide health care fraud “takedown,” an orchestrated event that this year involved a total of 601 charged defendants in 58 federal districts. Those charged included 165 doctors, nurses and other licensed professionals. The defendants included 76 doctors and 86 other individuals who were allegedly involved in unlawfully prescribing and distributing opioids and other narcotics.

CMS Announces Initiatives to Reduce Medicaid Fraud, Waste

Date: June 27, 2018 | Posted: Eric D. Fader | Topics: Electronic Health Records; Fraud and Abuse; Legislation and Public Policy; Medical Loss Ratio; Medicare and Medicaid; Reimbursement Matters; State Matters

On June 26, the Centers for Medicare & Medicaid Services (CMS) announced numerous initiatives to reduce fraud and waste in the Medicaid program. CMS Administrator Seema Verma discussed the new efforts at a briefing with reporters, and they are described in a CMS Medicaid Program Integrity Strategy fact sheet.

NJ “Surprise Bill” Restrictions Finally Become Law

Date: June 18, 2018 | Posted: Eric D. Fader | Topics: Hospitals and Institutions; Legislation and Public Policy; Private Insurers; Reimbursement Matters; State Matters

On June 1, New Jersey Governor Phil Murphy signed into law the “Out-of-network Consumer Protection, Transparency, Cost Containment and Accountability Act,” making New Jersey the latest state to restrict “surprise” medical bills. A previous attempt to do so in the state was discussed here. New York, Connecticut, Florida, California, and a handful of other states have similar laws.

FDA Releases Long-Awaited Off-Label Guidance

Date: June 13, 2018 | Posted: Susan R. Huntington | Topics: FDA; Life Sciences; Medical Devices; Pharmaceuticals

On June 12, the U.S. Food and Drug Administration (FDA) published two new guidance documents that address how companies can share off-label information with insurers and healthcare professionals about drugs and medical devices, as well as information for uses that haven’t yet been approved.

Feds Get Dinged for Subpar Health-Care Cybersecurity

Date: June 08, 2018 | Posted: Day Pitney | Topics: Electronic Health Records; Legislation and Public Policy; Privacy and Data Protection

A June 6 article in Bloomberg Law’s Health Law & Life Sciences News, "Feds Get Dinged for Subpar Health-Care Cybersecurity," discussed a letter that was recently released by members of the House Energy and Commerce Committee and the Senate Health, Education, Labor, and Pensions Committee. The letter asked the U.S. Department of Health and Human Services (HHS) to update its cybersecurity plans and provide guidance on how it will coordinate efforts among various agencies. Day Pitney’s Eric Fader was quoted in the article.

Yet Another Delay for 340B Drug Pricing Program Rule

Date: June 05, 2018 | Posted: Eric D. Fader | Topics: Hospitals and Institutions; Legislation and Public Policy; Medicare and Medicaid; Pharmaceuticals

On June 5, the Health Resources and Services Administration, part of the U.S. Department of Health and Human Services, published a final rule that further delays the effective date of the January 5, 2017 final rule on calculation of drug price ceilings and the imposition of civil monetary penalties for manufacturers that knowingly and intentionally overcharge covered entities under the 340B Drug Pricing Program.

Day Pitney LLP

Practice Groups

Additional Day Pitney Blogs

Topics

Subscribe