The Centers for Medicare & Medicaid Services’ Transparency in Coverage Final Rule took effect on July 1, following a six-month delay in implementation to allow payers to come into compliance.
The Final Rule requires group health plans and health insurance issuers offering non-grandfathered coverage in the group and individual markets to disclose online, in machine-readable
On July 13, the New York Office of Medicaid Inspector General (OMIG) published proposed regulations implementing 2020 changes to law relating to provider compliance programs, Medicaid managed care fraud, waste and abuse prevention programs, and OMIG’s self-disclosure program. The proposed changes will significantly affect both payers and providers alike.
In the next installment of Rivkin
Rivkin Radler’s Michael Sirignano authored a recent article for the New York Law Journal entitled “The Anti-Kickback Statute’s Role in Health Insurance Fraud Cases.” The article discussed recent lawsuits against physicians, laboratories, hospitals, and a large pharmaceutical company, McKesson Corporation, under the False Claims Act and federal Anti-Kickback Statute.
On June 13, the U.S. Department of Health and Human Services (HHS) issued guidance to explain how audio-only telehealth can comply with HIPAA, while also emphasizing that this mode of telehealth services can expand healthcare access to individuals who may have limited internet and broadband capabilities.
In response to the COVID-19 pandemic in March 2020,
On Thursday, June 16, in the next installment of Rivkin Radler’s Healthcare Lunch & Learn series, firm partners Frank Izzo and Wendy Sheinberg will present a program on Addressing Patient Capacity Issues. The program will take place from 12:00 noon to 1:00 PM Eastern time via Zoom.
The topics to be covered will include:
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
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
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
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
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