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
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.

Telemedicine Facing Increased Government Scrutiny

Date: April 20, 2018 | Posted: Day Pitney | Topics: Fraud and Abuse; Hospitals and Institutions; Legislation and Public Policy; Medicare and Medicaid; Reimbursement Matters

An April 20 article in Bloomberg Law's Health Law & Life Sciences News, "Telemedicine Facing Increased Government Scrutiny," discussed the increasing scrutiny of telemedicine services by government agencies as questions regarding fraud, waste, and abuse increase. Day Pitney's Eric Fader was quoted in the article.

Horizon Didn't Justify Sealing Tiered Plan Docs, Judge Says

Date: April 20, 2018 | Posted: Day Pitney | Topics: Hospitals and Institutions; Litigation; Private Insurers; State Matters

An April 13 article in Law360, "Horizon Didn't Justify Sealing Tiered Plan Docs, Judge Says," discussed a recent decision by Bergen County Superior Court Judge Robert Contillo ordering Horizon Blue Cross Blue Shield to disclose a report from McKinsey & Co. that helped Horizon develop its OMNIA tiered insurance plan. Day Pitney's Michael Furey was quoted in the article.

Judge Orders Horizon to Let Public See Details Behind OMNIA Insurance Plan

Date: April 14, 2018 | Posted: Day Pitney | Topics: Hospitals and Institutions; Litigation; Private Insurers; State Matters

An April 12 article in NJ Spotlight, "Judge Orders Horizon to Let Public See Details Behind OMNIA Insurance Plan," discussed the Bergen County Superior Court’s order that Horizon Blue Cross Blue Shield disclose a report from McKinsey & Co. that Horizon used to determine the healthcare providers to be included in its two-tiered OMNIA plan. Day Pitney’s Mike Furey was quoted in the article.

Virtua Medical Group to Pay $418,000 Data Breach Settlement

Date: April 11, 2018 | Posted: Eric D. Fader | Topics: Electronic Health Records; HIPAA and the HITECH Act; Home Healthcare; Hospitals and Institutions; Litigation; Privacy and Data Protection; State Matters

Virtua Medical Group, a health network with more than 50 medical and surgical practices in southern New Jersey, has agreed to pay a $417,816 fine to settle allegations that it failed to properly protect its patients’ privacy. The State Office of the Attorney General (AG) and Division of Consumer Affairs announced the settlement in a joint press release on April 4. The settlement is notable as one of the few instances to date in which state regulators have stepped in to enforce HIPAA rules in connection with a data breach.

New Medicare Cards Could Spell Trouble for Doctors, Seniors

Date: April 09, 2018 | Posted: Day Pitney | Topics: Electronic Health Records; Legislation and Public Policy; Medicare and Medicaid; Privacy and Data Protection

A March 30 article in Health Care on Bloomberg Law, "New Medicare Cards Could Spell Trouble for Doctors, Seniors," discussed whether new Medicare identification cards that do not contain Social Security numbers will deter fraud or end up encouraging scammers and hindering physician billing. Day Pitney’s Eric Fader was quoted in the article.

Ambulance Provider Settles False Claims Allegations for $9 Million

Date: April 09, 2018 | Posted: Day Pitney | Topics: Fraud and Abuse; Litigation; Medicare and Medicaid; White Collar

The U.S. Department of Justice announced on March 28 that Medical Transport, a Virginia-based ambulance service provider, agreed to pay $9 million to resolve allegations that it submitted false claims for ambulance transports in violation of the False Claims Act. Specifically, the government alleged that Medical Transport submitted false or fraudulent claims to Medicare, Medicaid and TRICARE for medically unnecessary ambulance rides and improperly billed rides to federal healthcare programs when they should have been billed to other payers.

Oncology Company to Pay Up to $11.5 Million to Settle Kickback Allegations

Date: April 06, 2018 | Posted: Erin Healy | Topics: Fraud and Abuse; Litigation; Medicare and Medicaid; White Collar

SightLine Health, LLC, a Texas-based radiation therapy company, has agreed to pay the federal government up to $11.5 million to resolve allegations that the company paid referring physicians kickbacks in the form of investment opportunities and ownership dividends. Integrated Oncology Network Holdings (“ION”), which acquired SightLine as part of a strategic investment in 2011, and other SightLine subsidiaries were also implicated in the settlement.

CMS Extends MIPS 2017 Data Submission Deadline

Date: March 30, 2018 | Posted: Susan R. Huntington | Topics: Legislation and Public Policy; Medicare and Medicaid; Reimbursement Matters

With the March 31 deadline fast approaching, the Centers for Medicaid & Medicare Services (CMS) announced on March 29 that eligible clinicians participating in the Quality Payment Program under the Medicare Access and CHIP Reauthorization Act (MACRA) will have until Tuesday, April 3, 2018 at 8:00 PM EDT to submit their 2017 Merit-based Incentive Payment System (MIPS) performance data.

CenterLight Healthcare Reaches $10M Medicaid Fraud Settlement

Date: March 29, 2018 | Posted: Eric D. Fader | Topics: Fraud and Abuse; Home Healthcare; Litigation; Medicare and Medicaid; Reimbursement Matters; State Matters; White Collar

CenterLight Healthcare, a managed long-term care organization that provides and coordinates healthcare services in the New York City area, has agreed to a $10.3 million settlement with state and federal prosecutors. New York Attorney General Eric Schneiderman announced the joint settlement on March 28.

States Consider Individual Mandates

Date: March 28, 2018 | Posted: Eric D. Fader | Topics: Affordable Care Act; Legislation and Public Policy; Private Insurers; State Matters

Although the recently passed federal tax reform law included a provision repealing the Affordable Care Act’s (ACA’s) individual mandate in 2019, a number of states are considering adopting their own requirements that individuals maintain health insurance or pay a penalty.

Day Pitney LLP

Practice Groups

Additional Day Pitney Blogs

Topics

Subscribe