October was a busy month for the Office for Civil Rights (“OCR”) as it handed down one settlement and one civil monetary penalty for HIPAA violations and secured corrective action in a third case involving allegations of discrimination. With each enforcement announcement, OCR continues to send a message to health […]
Health Law Alert
CMS/OIG Issue Long Anticipated Stark and Anti-Kickback Proposed Rules
For quite some time, many in the industry have anticipated new rulemaking from CMS and the OIG related to the Stark law and the Federal Anti-Kickback Statute. Furthering the “Regulatory Sprint” to care coordination and value-based care, the agencies have delivered. In a coordinated effort, on October 17, 2019, CMS […]
Changes to CMS Enrollment and Enforcement Authority Designed to Close Loopholes for Bad Actors
On September 10, 2019, CMS published a Final Rule called Program Integrity Enhancements to the Provider Enrollment Process (CMS-6058-FC) with a comment period to be effective November 4, 2019. In previous enrollment changes establishing higher scrutiny for some provider/supplier types, CMS expressed its goal of stopping the “pay and chase” […]
‘Site-Neutrality’ Policy is Thrown Out by Federal District Court
On September 17, 2019, US District Judge Rosemary Collyer of the District of Columbia struck down CMS’ policy included in the CY2019 Outpatient Prospective Payment System (OPPS) rule that cut Medicare payment rates to hospitals offering physician services. The policy established payment for medical services provided in off-campus, hospital outpatient […]
OCR Announces First Individual Right of Access Enforcement Action
Earlier this year, the U.S. Department of Health and Human Services, Office for Civil Rights (OCR) announced that it would vigorously enforce the rights of patients to receive copies of their medical records in a timely fashion. OCR held true to its word, and, on September 9, 2019, announced the […]