The U.S. Department of Justice (DOJ) announced on March 3 that Ameet Goyal, M.D., a Westchester-based ophthalmologist, was sentenced to 96 months in prison for falsely billing for millions of dollars of upcoded procedures over seven years, and for fraudulently obtaining two business loans under the CARES Act’s Paycheck Protection Program (PPP) in the early
Texas Court Vacates No Surprises Act Dispute Resolution Rule
In a February 23 order, the U.S. District Court for the Eastern District of Texas vacated a controversial rule issued in September that implemented the independent dispute resolution (IDR) procedure under the federal No Surprises Act (NSA). The lawsuit[1] was brought by the Texas Medical Association. Numerous industry participants had complained that the
HHS Report Warns of EMR and EHR Security Risks
The U.S. Department of Health and Human Services’ Health Sector Cybersecurity Coordination Center (HC3) recently issued a report entitled “Electronic Medical Records in Healthcare” that discussed security risks applicable to electronic medical records (EMRs) and electronic health records (EHRs). EHRs and EMRs are prime targets for cyber attackers because protected health information (PHI)
New Proposed Bills Would Extend Telehealth Waivers, Modernize HIPAA
We don’t often cover brand-new proposed legislation on Rivkin Rounds, generally preferring to wait until it’s closer to becoming law. However, two bipartisan bills introduced in Congress last week are worthy of mention.
The Telehealth Extension and Evaluation Act would allow the Centers for Medicare & Medicaid Services to extend certain pandemic-era flexibilities in Medicare
NY to Fund New Behavioral Health Stabilization Centers
New York Gov. Kathy Hochul announced on February 2 that the state will make available more than $100 million in funding over the next five years for 12 new Intensive Crisis Stabilization Centers across the state. The facilities are akin to urgent care centers for people who are experiencing an acute behavioral health crisis.
Intensive
EyeMed Fined $600K for 2020 Data Breach
On January 24, New York Attorney General Letitia James announced a settlement with EyeMed Vision Care LLC based on shortcomings in the company’s data security procedures. The problems were discovered during the state’s investigation of a 2020 data breach that affected 2.1 million people.
EyeMed, owned by Italian eyeware giant Luxottica Group PIVA, provides vision
Provider Requirements Under the No Surprises Act
The federal No Surprises Act, effective January 1, 2022, established new requirements for healthcare providers, facilities, and providers of air ambulance services to protect consumers from “surprise” medical bills. These requirements are in addition to applicable state laws regulating balance billing and surprise bills.
If a consumer receives care from an out-of-network provider, the patient’s
High Court to Hear Oral Arguments on Challenges to COVID-19 Mandates
On January 7, the U.S. Supreme Court will hear oral arguments pursuant to emergency requests in two cases concerning COVID-19 mandates. One case involves a challenge by a coalition of interest groups and states opposed to the Occupational Safety and Health Administration’s mandate, which requires employees of businesses with 100 or more employees to receive
CT DPH Suspends Licensure Requirement for Out-of-State Providers; NY Extends Waivers
On December 22, the Connecticut Department of Public Health (DPH) announced that it issued an Order temporarily suspending the requirements for state licensure, certification or registration of physicians, nurses, and certain behavioral health providers who are licensed elsewhere in the U.S. or the District of Columbia. The Order will expire on February 15, 2022, if
Medicare Telehealth Use Increased 63-fold in 2020
A study recently released by the U.S. Department of Health and Human Services (HHS) found that the number of beneficiaries in the traditional Medicare program who used telehealth increased from 840,000 in 2019 to nearly 52.7 million in 2020. At the same time, the number of visits to doctors’ offices reimbursed under Part B decreased.