In a recent Advisory Opinion, the U.S. Department of Health and Human Services’ Office of Inspector General (OIG) determined that an arrangement involving certain physicians who have an ownership interest in a medical device company that manufactures products that may be ordered by the physician owners (the “Company”) was not considered a suspect physician-owned
Transitioning to a DSO: An Emerging Trend in Orthodontic Practice Transitions
Over the last several years, the dental services industry has become increasingly consolidated, creating significant financial opportunities for investors as well as financial and exit opportunities for dentists. This consolidation has been driven in large part by Dental Services Organizations (DSOs) formed by dentists and/or private financial investors (e.g., private equity) through the acquisition of
New NY Agency Established to Oversee PBMs
On May 11, New York Gov. Kathy Hochul announced the establishment of the Pharmacy Benefits Bureau within the State’s Department of Financial Services (DFS). The Bureau will handle the licensing and supervision of pharmacy benefit managers (PBMs), and in particular their impact on consumers and the cost of healthcare. The Bureau will also have authority
Did Your Practice Get Burned Online? Reach Out — and Redirect
An article published on May 16 in Part B News, “Did your practice get burned online? Reach out — and redirect,” discussed how (or whether) professional practices should respond to negative reviews online from patients. Rivkin Radler’s Eric Fader was quoted in the article.
Eric said that he advised one of his
Prepare and Monitor: Take Extra Steps when the Patient’s a Medical Tourist
An article published on May 16 in Part B News, “Prepare and monitor: Take extra steps when the patient’s a medical tourist,” discussed issues that U.S. medical practices can face when a patient receives medical treatment abroad. The medical tourism industry has been growing rapidly, led by a demand for cosmetic surgery
NYS Budget Aims to Keep Network of CDPAP Fiscal Intermediaries Intact
In December 2019, the New York State Department of Health (DOH) issued a Request for Offers (RFO) from fiscal intermediaries (FIs) to enter into contracts with the DOH to provide FI services in the Consumer Directed Personal Assistance Program (CDPAP) for persons enrolled in Medicaid fee-for-service and Medicaid managed care programs. The CDPAP provides services
FTC Appears Ready to Begin Enforcing Its Health Breach Notification Rule
Rivkin Radler’s Shari Claire Lewis wrote an article, “FTC Appears Ready to Begin Enforcing Its Health Breach Notification Rule,” that was published in the New York Law Journal on April 18. The article discusses the Federal Trade Commission’s rule that requires manufacturers of connected medical devices, fitness trackers and other wearables, and health
DOJ Intervenes in Kickback Lawsuit Against Lab and Hospital Execs
The U.S. Department of Justice (DOJ) recently intervened in an action filed in Texas against two laboratory CEOs, one hospital CEO, and numerous other executives, employees, and recruiters, seeking civil penalties and treble damages for violations of the False Claims Act. The DOJ’s complaint, which was unsealed on April 4, also alleges that the fraudulent
HHS Issues Guidance Clarifying Obligations of HIPAA Covered Entities
On March 22, the U.S. Department of Health and Human Services (HHS) issued guidance clarifying the obligations of covered entities to require their business associates to comply with HIPAA Administrative Simplification requirements related to standards for electronic health care transactions, code sets, unique identifiers, and operating rules.
While these requirements apply only to covered entities,
ACO REACH Tweaks Help Smaller Group Practices, Promote Health Equity
A March 21 article in Part B News, ACO REACH tweaks help smaller group practices, promote health equity,” discussed the Accountable Care Organization (ACO) Realizing Equity, Access and Community Health (REACH) model, which was announced on February 24 as a replacement for the CMS Global and Professional Direct Contracting (GPDC) model. Both programs are