As previously discussed here, Johnson & Johnson (J&J) recently announced its intention to change its 340B Drug Pricing Program discount available to disproportionate share hospital (DSH) Covered Entities on purchases of STELARA and XARELTO. However, the Health Resources and Services Administration (HRSA) notified J&J that its rebate model was contrary to the 340B statute
Hospitals
J&J Announces New Rebate Model for 340B Program, but HRSA Pushes Back
On August 23, Johnson & Johnson (J&J) announced changes to its 340B Drug Pricing Program discount available to disproportionate share hospital (DSH) Covered Entities on purchases of two of J&J’s most popular drugs, STELARA and XARELTO.
As of October 15, J&J will make a 340B discount on these drugs available through a rebate. According to…
Know When to Bill Facility Fee for Telehealth Services!
The U.S. Attorney’s Office for the District of Connecticut recently announced that Supportive Care Holdings, LLC and its related companies agreed to pay the federal government nearly $4,600,000 to resolve allegations of submitting false claims. The Supportive Care companies provide behavioral health services via telehealth to patients residing in skilled nursing facilities.
Supportive Care’s companies…
OCR Announces Third Ransomware Settlement as Threats Continue to Rise
On July 1, the U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) announced that Heritage Valley Health System, a provider in Pennsylvania, Ohio and West Virginia, agreed to pay $950,000 to resolve potential violations of the HIPAA Security Rule. Heritage Valley’s alleged violations included failure to conduct a risk analysis to…
HHS OIG Issues Information-Blocking Disincentives for Certain Health Care Providers
On June 24, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) announced a final rule that establishes disincentives for certain health care providers that have committed information blocking, or any activity that is likely to hamper access, exchange, or use of electronic protected health information (PHI). This rule…
Fader Co-Authors Article, Presents Podcast on Neuromonitoring “Surgeon Deals”
Rivkin Radler Partner Eric Fader co-authored an article in the March-April issue of SpineLine, the magazine of the North American Spine Society (NASS). The article, “OIG Advisory Opinion Cautions Against ‘Surgeon Deals’ in Neuromonitoring,” was written with Rich Vogel, PhD, DABNM, FASNM, the current President of the American Society of Neurophysiological Monitoring…
MA Hospital Pays $24 Million to Settle FCA Case
On May 16, the U.S. Attorney’s Office for the District of Massachusetts announced that Cape Cod Hospital agreed to pay $24.3 million to resolve alleged violations of the federal False Claims Act (FCA) for knowingly failing to follow Medicare’s requirements for certain procedures performed.
Beginning in 2015, the hospital offered transcatheter aortic valve replacement (TAVR)…
NY Joins List of States Prohibiting Geofencing Near Healthcare Facilities
Rivkin Radler’s Frank Izzo and Jeff Ehrhardt authored an article in the Spring 2024 issue of USLAW magazine, “New York Joins List of States Prohibiting Geofencing Near Healthcare Facilities.” The article discussed geofencing laws, enacted partly in response to the Supreme Court Dobbs decision, in depth by state.
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Montefiore Medical Center Settles HIPAA Breach for $4.75 Million
On February 6, the U.S. Department of Health and Human Services (HHS) announced a $4.75 million settlement with Montefiore Medical Center (MMC) for a breach of unsecured electronic protected health information (ePHI). The settlement stems from an internal investigation that found that an employee of the New York hospital system sold patient information to an…
Prohibitions on Provider Inducements
On Tuesday, February 27, in the next installment of Rivkin Radler’s Healthcare Compliance Lunch & Learn series, Rivkin Radler partners Jeff Kaiser and Ben Malerba will present “Prohibitions on Provider Inducements.” The program will take place from 12:00 noon to 1:00 PM Eastern time via Zoom.
Some of the topics covered will be:
- A discussion