Health care transactions can be complex, given the regulatory maze of health care laws and regulations applicable to the entities involved. One way to help mitigate the risks inherent in such transactions is through representations and warranties insurance (“R&W insurance”), which can be purchased by a buyer or seller. R&W insurance is becoming more common
Telehealth providers should remain aware of Medicaid payments review
The expansion of telehealth is changing the landscape of health care. This is the third in a four-part series exploring what providers should know about this growing area.
Medicaid programs pay for telemedicine, telehealth and telemonitoring services delivered through a range of interactive video, audio or data transmission (telecommunications). Various state Medicaid programs are experiencing
CMS finally issues draft guidance on hospital co-location, requests comments
Many hospitals share space with other health care entities. Despite this, the Centers for Medicare & Medicaid Services (CMS) has given mixed signals — and never issued formal guidance — concerning the permissibility of shared spaces under the Medicare Conditions of Participation (CoP). This has created great confusion and uncertainty for hospitals as they try
Illegal kickback schemes on the rise in light of opioid crisis
According to the Department of Justice (DOJ), the opioid crisis in the United States is now a national public health emergency. Unfortunately, such pervasive opioid use is presenting prime opportunities for drug manufacturers, health care providers and pharmacies to make money by engaging in various illegal kickback schemes.
In the past 10 years, regulatory scrutiny
HHS revises annual limits on HIPAA fines
On April 23, 2019, the U.S. Department of Health & Human Services (HHS) published a Notification of Enforcement Discretion Regarding HIPAA Civil Money Penalties (CMP) outlining interim annual limits for HIPAA violations. HHS believes the revised annual limits “reflect the most logical reading of the HITECH Act.” These amounts are subject to change pending further
Are Missouri hospitals and health care providers marijuana-ready?
In November 2018, Missouri became the 33rd state to approve the use of medical marijuana, and rules and regulations for medical marijuana are being drafted by the Missouri Department of Health & Senior Services (DHHS). On March 15, 2019, DHSS released more draft rules. Of the published draft rules, there is only one set
Medicare coverage for telehealth has expanded but still has limits
The expansion of telehealth is changing the landscape of health care. This is the second in a four-part series exploring what providers should know about this growing area.
Before 2015, Medicare did not pay separately for telehealth, and telehealth and telemedicine services were bundled into “evaluation and management” codes. However, in 2015, the Center for
Hospitals with multiple practice locations face ‘exact address’ claim rejections
The Centers for Medicare & Medicaid Services (CMS) has found that hospitals are increasingly operating “off-campus, outpatient, provider-based” departments. Services provided at these off-campus facilities are required to be billed using the off-campus facility’s address so that payment can be accurately made under the Medicare Physician Fee Schedule (MPFS) or the Outpatient Prospective Payment System
Navigating regulations and risks in the expanding world of telehealth
The expansion of telehealth is changing the landscape of health care. This is the first in a four-part series exploring what providers should know about this growing area.
Health care providers and patients are relying more heavily on telehealth for the provision of health care. The rise of telehealth is changing the landscape of how
New association health plan rules vacated, but old rules still valid
The battle over health benefits rages on. In the latest salvo, a group of states scored a major court victory against the Trump administration’s new “Association Health Plan” Final Rule, which was finalized in 2018. While this decision will have major ramifications, it is important to remember that association health plans may still be