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Photo of Healthcare Law Blog Christopher J. Shaughnessy
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cshaughnessy@mmlk.com
859-231-8780, ext. 251
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Healthcare law is constantly changing and requires you to stay abreast of the changes in the law. There is never a dull moment in the healthcare industry. The government will quickly …

Showing 15 posts by Christopher J. Shaughnessy.

CMS Executes About-Face on Pre-Dispute Arbitration Ban

The Centers for Medicare & Medicaid Services (“CMS”) published a proposed rule on June 5, 2017, that serves as an effective course reversal on pre-dispute arbitration agreements in a long-term care (“LTC”) setting. This caps off an effort by many in the healthcare and nursing home industry to stop the prior rule, which banned such agreements, from taking effect. More >

Kentucky’s HB 333 and Schedule II Drug Prescriptions – What Providers Need to Know

On April 10th, 2017, Gov. Bevin signed HB 333 into law, adding another tool to an ever-necessary arsenal to combat Kentucky’s opioid epidemic. While the new law should serve to help curb painkiller abuse, it adds new regulations to physicians in an already heavily-regulated area of practice. Providers must now understand the new restrictions and adjust their pain management practices to accommodate them. More >

Implied False Certification - Supreme Court Upholds New False Claims Act Standard

While the news for healthcare practitioners regarding regulatory liability under Federal law had largely been positive as of late, the Supreme Court of the United States upheld a new standard of liability under the False Claims Act in the case of Universal Health Services v. United States ex rel. Escobar. The standard of liability approved by SCOTUS is referred to as “implied false certification” and the implications for healthcare providers are numerous. More >

Recap of the Webinar, "What Providers Should Know: Overpayments and the False Claims Act"

On May 24th and 25th, 2016, McBrayer held a webinar on what providers should know regarding overpayments and the False Claims Act.  Lisa English Hinkle and Chris Shaughnessy, McBrayer healthcare law attorneys, guided participants through the interplay between overpayments from various federal healthcare programs and violations of the False Claims Act that can accrue heavy penalties. For further information on this webinar, contact McBrayer’s Marketing Director, Morgan Hall, at mhall@mmlk.com or 859-231-8780.

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Some of the information shared by the presenters is also summarized below. More >

New Guidance Maps HIPAA Security Rule to NIST Cybersecurity Framework to Help Providers Manage Cybersecurity Risk

In a world of looming data breaches and significant penalties for the release of protected health information, the complexities of cybersecurity and compliance with the HIPAA Security Rule can be incredibly daunting. In 2014, in response to the growing threat of data breaches, the National Institute of Standards and Technology (“NIST”) released the Framework for Improving Critical Infrastructure Cybersecurity (“the Framework”) as a means to standardize best practices in cybersecurity across organizations. To assist providers with implementing the Framework while remaining in compliance with the HIPAA Security Rule, the Department of Health and Humans Services Office for Civil Rights (“OCR”) published a HIPAA Security Rule Crosswalk (“the Crosswalk”) to tie the standards together and help strengthen cybersecurity preparedness. More >

OIG Alert Shows Increased Concern over Data Blocking

In a report to Congress last April, the Office of the National Coordinator for Health Technology addressed the growing issue of data blocking. Data blocking occurs when some person or entity knowingly and unreasonably interferes with the exchange or use of electronic health information (“EHI”), and this happens due to business incentives that cause those persons or entities to want to control and limit availability to that information. For instance, if one ACO has the capability to send EHI of a patient safely and securely to another ACO treating that patient through a certified health IT system, but instead faxes that patient’s information, it has engaged in data blocking. It has made it more difficult, inefficient and expensive for the rival ACO to treat that patient. In essence, data blocking prevents the exact purpose of the HITECH Act and provisions of the Affordable Care Act which were designed to increase interoperability of electronic health information systems and facilitate the exchange of information. These broad concerns over data blocking found footing in a recent Office of Inspector General (“OIG”) Alert stressing that data blocking can run afoul of the Federal Anti-Kickback Statute. More >

FCC Guidance on Cellphones Puts the Squeeze on Medical Debt Collectors

In July, the FCC released an order it touted as strengthening “consumer protections against unwanted calls and texts.” It was a series of rulings based on the Telephone Consumer Protection Act meant to clarify the use of autodialers, procedures for wrong numbers and consent to call, mainly concerning cellphones. Under these new regulations, healthcare providers must get express written consent to be able to contact patients on their mobile phones about medical debt and billing. More >

Providers Wary after First Ruling on 60-Day Rule

The False Claims Act (“FCA”) is already a minefield for healthcare providers, especially when coupled with the Stark Law. Treble damages and fines of up to $11,000 per violation add up quickly under the FCA. The U.S. District Court for the Southern District of New York just made further FCA “reverse false claims” nightmares that much more of a reality in the case of Kane v. Healthfirst. That case is illustrative of how the government will interpret and enforce the Centers for Medicare & Medicaid Services’ (“CMS”) “60-day rule” for retention of overpayments, and the result should make all healthcare providers take notice. More >

Structuring Healthcare Provider Agreements for Compliance

On June 23rd, the Healthcare Law Blog discussed the Fraud Alert recently issued by the Office of Inspector General of the United States Department of Health and Human Services regarding physician compensation arrangements which telegraphed the Office of Inspector General’s intention to increase scrutiny of financial arrangements between physicians and providers to whom physicians make referrals. In today’s post, we examine the steps physicians and other healthcare providers should take to ensure that any financial relationships are in compliance with federal statutes and regulations. More >

OIG Fraud Alert Targets Physician Compensation Arrangements

It bears repeating so much that even the Office of Inspector General of the Department of Health and Human Services just issued a Fraud Alert on it – physician compensation arrangements are fraught with potential violations of the Anti-Kickback Statute (“AKS”) as well as the Stark Statute and regulations. The AKS is a large enough trap that it catches even the most above-board agreements in its net, and physicians should be wary of the implications. Likewise, the Stark Statute and regulations are broad and are strict liability laws: if you do not meet a Stark exception, the referral and the resulting claim are tainted and the money received based upon the tainted claim must be repaid to the government. More >

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mcbrayer/media_files/video/Webinar-WhatProvidersShouldKnow-OverpaymentsandtheFCA.mp4