Health Care Today | Health Law Blog

Greensfelder attorney Lucie Huger was featured in Relias Media's Hospital Access Management HIPAA Regulatory Alert article entitled, “Avoid Most Common HIPAA Violations With Best Practices, Education.”

An excerpt of the article is as follows:

HIPAA breaches can happen even to the best prepared healthcare organizations, but knowing the most common failings can improve your chances of staying in the good graces of the Office for Civil Rights (OCR).

As of Nov. 1, 2019, hospitals — as well as other types of health care providers — submitting claims to Missouri or Illinois Medicaid programs will be subject to a new restrictive rule concerning ordering, referring and prescribing providers (ORP). The ORP rule may result in hospitals unexpectedly having some Medicaid claims denied. Below is a description of the rule, some differences between Missouri and Illinois, where the rule comes from, and what claims it applies to.

Oklahoma is making history in its pending multi-billion-dollar opioid case against Johnson & Johnson, in which the state is accusing the drug manufacturer of irresponsible marketing practices that allowed it to profit from the opioid crisis. The parties await a final decision from Oklahoma Circuit Judge Thad Balkman after a seven-week bench trial that concluded July 15.

Starting on Jan. 1, 2020, Illinois residents and visitors over age 21 are allowed to purchase, possess, use, or transport cannabis for recreational purposes. Illinois’ legalization of recreational cannabis under state law will impact Illinois and Missouri employers because the drug will be more accessible to their employees.

Certain treatments for chronic conditions can now be covered by high deductible health plans (HDHPs) as preventive care before the deductible is met. Pursuant to an executive order, a new IRS notice will allow individuals with certain conditions, such as asthma or diabetes, to obtain coverage for treatments and medications, such as inhalers and insulin, without first meeting their high deductible.

This is Part 1 in a two-part series. Part 1 will focus on employee non-compete assignability in asset purchase transactions, and Part 2 will address stock purchase or merger transactions.

Health care employers such as medical groups or hospitals have a valuable stake in protecting their businesses interests by having covenants not to compete in place for important employees such as physicians. Whether these non-competes are assignable by a seller to a buyer can be an important consideration in structuring a business transaction involving the purchase of a health care business enterprise.

The Office of Civil Rights (OCR) within the Department of Health and Human Services (HHS) has been able to hold “business associates” directly liable for certain HIPAA violations since 2009, with the passage of the Health Information Technology for Economic and Clinical Health (HITECH) Act. Under HIPAA, a “business associate” is an entity that receives protected health information (PHI) in order to provide services to a “covered entity” (such as a health care provider, a health plan, or a heath care clearinghouse).

There has been a lot of movement throughout the country on the state level to prevent patients from receiving surprise medical bills when they receive unanticipated care from out-of-network providers while seeking care from in-network providers. For example, in 2018, Missouri passed such legislation, which banned surprise medical bills for patients who are treated by an out-of-network physician at an in-network emergency room.

The expansion of telehealth is changing the landscape of health care. This is the final installment in a four-part series exploring what providers should know about this growing area.

There are many business models and provider arrangements for the provision of telehealth. Given the regulatory climate and increasing use of telehealth by health care providers and patients, these business models and provider arrangements are continuing to change.

On May 24, 2019, the U.S. Department of Health & Human Services (HHS) announced that it is issuing proposed revised regulations under Section 1557 of the Affordable Care Act that remove the redefinition of “sex” and certain regulatory burdens, including language taglines. The changes substantially roll back the original Obama-era regulations.