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New York Healthcare Law Bulletin Archives
Spring 2014
QUARTERLY SUMMARY OF STATE LAW DEVELOPMENTS
  • Health Care Providers Can Sue Insurers Who Violate Prompt Pay Law
  • New York Court of Appeals Limits A Health Care Employer’s Liability for Employee’s Unauthorized Disclosure of Confidential Patient Information
  • NYS PHHPC Proposes Greater DOH Oversight of Ambulatory Delivery Models
  • Hospitals Now Required to Give Patients Notice When They Are Placed On Observation Status
  • New Reporting Regulation Requires NYC Hospitals To Report Psychosis Diagnoses
  • NYS DOH Finalizes Policies For Transition of the Medicaid Nursing Home Benefit and Population Into Managed Care
  • Podiatry Scope of Practice Expanded to Include Ankle Surgery Privileges

QUARTERLY SUMMARY OF FEDERAL LAW DEVELOPMENTS

  • More Delays for Enforcement of the Medicare Two Midnight Rule

  • HHS and CMS Permit Patients Direct Access to Laboratory Test Results

  • Protections for Electronic Health Record Donations Extended

  • Rules Require That Providers Who Bill “Incident To” Must Comply with Applicable State Laws

  • IRS Notices Affecting Tax-Exempt Hospitals

  • OIG Issues Work Plan for 2014

  • OIG Approves Percentage-based Compensation for a Placement Agency’s Referrals to Senior Residential Communities

Winter 2014
QUARTERLY SUMMARY OF STATE LAW DEVELOPMENTS
  • New York Court of Appeals Finds That OMIG's Exclusion of A Physician Was Arbitrary and Capricious And An Abuse of Discretion
  • Governor Cuomo Bans Doctors and Other Health Care Providers From Billing New York’s No-Fault Auto Insurance System
  • Recently Enacted New York State Health Care Legislation
  • DOH Issues Dear Administrator Letter On New Smoking Ban And Addresses Industry Questions
  • DOH Issues Dear Administrator Letter On OASIS Requirements for CHHAs and LTHHCPs and Managed Long Term Care Plan Transitions
  • OMIG Compliance Certification
  • Ordering/Referring Editing Implementation

QUARTERLY SUMMARY OF FEDERAL LAW DEVELOPMENTS

  • Tuomey Judgment: $237.5 Million for Stark/FCA Violations

  • FDA Authority Over Compounding Pharmacies

  • Final Rules Published on Mental Health Parity

  • CMS Publishes Several Final Rules Affecting Medicare Policy and Payment for Calendar Year (CY) 2014

  • CMS Delays Enforcement of the 'Two-Midnight' Rule

  • Ordering and Referring Denial Edits Will Be Implemented on January 6, 2014

  • HHS Clarifies That Qualified Health Plans Under the Affordable Care Act Are Not Federal Health Care Programs

  • CMS Issues Two New Advisory Opinions Involving a Clinical Lab Providing Free Devices to Referring Physicians

  • OIG Publishes 2014–2018 Strategic Plan

  • OIG Advisory Opinion 13-15

  • HHS Issues Guidance on Disclosures to Law Enforcement and Marketing Practices

  • OCR Delays Enforcement of HIPAA Requirement for Certain CLIA and CLIA-Exempt Laboratories to Revise their Notices of Privacy Practices

Summer 2013
QUARTERLY SUMMARY OF STATE LAW DEVELOPMENTS
  • Practitioners Now Required to Check A Patient’s Controlled Substance History Prior to Prescribing Schedule II, III or IV Controlled Substances
  • DOH Issues Guidance for Hospitals Regarding Compliance with New Sepsis Regulations
  • New Health Care Legislation
  • 2012 Managed Care Legislation Takes Effect
  • New Regulations Regarding Prevention of Influenza Transmission by Healthcare Personnel
  • Medicaid Provider Enrollment Requirement
  • OMIG Updates Its Compliance Library
  • OMIG Recommends Annual Self-Assessment

QUARTERLY SUMMARY OF FEDERAL LAW DEVELOPMENTS

  • Enforcement of New HIPAA Rules Begins

  • Congressional Bill Introduced That Would Significantly Limit the Stark Exception for In-Office Ancillary Services

  • CMS Issues FY 2014 Inpatient Prospective Payment Final Rule

  • Other Regulatory Developments Regarding Fiscal Year 2014 Medicare Payment and Policy

  • CMS Issues Guidance On Policy Regarding Hospital Inpatient Admission Orders and Certifications

  • CMS Delays Enforcement of its DME Face-to-Face Requirement

  • New Regulation Requires Written Agreement Between Long Term Care Facilities and Hospice Providers

  • OIG Issues Report on Hospitals’ Use of Observation Stays and Short Inpatient Stays for Medicare Beneficiaries

  • OIG Issues Final Rule on Data Mining by State Medicaid Fraud Control Units

  • OIG Accepts Online Submissions of its Self-Disclosure Protocol

  • OIG Issues Negative Advisory Opinion on Proposed Agreement To Offer GPO Members an Equity Interest in GPO Parent Corporation

  • FDA Issues Several Guidance Documents

Spring 2013
QUARTERLY SUMMARY OF STATE LAW DEVELOPMENTS
  • DOH Adopts Final Regulations Limiting Executive Compensation and Administrative Expenses of State-Funded Providers
  • DOH Publishes Programmatic Guidance and Reimbursement Guidance Regarding Observation Services
QUARTERLY SUMMARY OF FEDERAL LAW DEVELOPMENTS
  • Jury Finds Health System Violated the Stark Law and False Claims Act as a Result of Its Physician Employment Contracts
  • Congress Seeks to Overhaul Medicare Auditing
  • Medicare Issues Proposed Rule to Allow Part A to Part B Rebilling in Hospitals
  • Proposed Rules for Fiscal Year 2014 Medicare Payment and Policy
  • CMS and OIG Issue Proposed Changes to the Federal Stark Law Exception and Anti-Kickback Statute Safe Harbor for Electronic Health Records Donations
  • OIG Issues An Updated Special Advisory Bulletin on the Effect of Exclusion from Participation in Federal Health Care Programs
  • OIG Updates Its Provider Self-Disclosure Protocol
  • U.S. Supreme Court Upholds Arbitration Decision in Oxford Health Case
  • Idaho State University Settles Alleged Violation of HIPAA Security Rule for $400,000
Winter 2013
QUARTERLY SUMMARY OF STATE LAW DEVELOPMENTS
  • Impact of the SAFE Act of 2013 on Mental Health Professionals in New York
  • Public Health and Health Planning Council Adopts Recommendations to Redesign the Certificate of Need (CON) Process
  • Second Circuit Reverses Conviction of a Pharmaceutical Sales Representative for Off-Label Promotion
  • DOH Issues Proposed Regulations For Electronic Prescribing and Dispensing of Controlled Substances
  • DOH Issues Proposed Regulations Requiring Hospitals to Adopt Protocols for the Early Identification and Treatment of Sepsis
  • DOH Issues Proposed Regulations to Improve the Quality and Oversight of Care Provided to Pediatric Patients
  • Governor Issues Executive Order Permitting Pharmacists to Administer the Flu Vaccine to Children
  • DOH Reminds Physicians to Update Their Physician Profiles
QUARTERLY SUMMARY OF FEDERAL LAW DEVELOPMENTS
  • OCR Publishes HIPAA/HITECH Omnibus Final Rule
  • CMS Publishes Final Sunshine Act Regulations
  • CMS Issues Proposed Rule That Would Reduce Administrative Burdens and Save Providers $676 Million Annually
  • New FTC Clinical Integration Advisory Opinion – Norman PHO
  • OIG Okays Pre-Filled Rx Forms
  • OIG Permits Hospital to Provide Physicians With Free Access to Electronic Interface
  • OIG Allows FQHC to Offer Gift Cards to Encourage Visits to the Health Center
  • OIG Issues Favorable Opinion on Co-Management Agreements
Fall 2012
QUARTERLY SUMMARY OF STATE LAW DEVELOPMENTS
  • New York Implements Federal Requirements Suspending Medicaid Payments for "Credible Allegations of Fraud"
  • OMIG's Authority to Audit Reimbursement Rates Upheld
  • Governor Vetoes Bill That Would Have Conformed the NY State Stark Law to the Federal Stark Law
  • DOH Revises Proposed Regulations Limiting Executive Compensation and Administrative Expenses of State-Funded Providers
  • Governor Signs Legislation Amending New York's ACO Law
  • New Legislation Governing Observation Services
  • Physical Therapists Now Required to Have Master's Degree
  • Profession of Polysomnographic Technology
  • Department of Financial Services Fines Oxford for Failure to Explain Coverage to Members
  • Appeals Court Finds Licensing Law Unconstitutional
QUARTERLY SUMMARY OF FEDERAL LAW DEVELOPMENTS
  • OIG Finds Improvements Are Needed at the ALJ Level of Medicare Appeals
  • FDA Issues Draft Guidance Regarding an IRB's Responsibility
  • DOJ and SEC Issue Long Awaited FCPA Guidance
  • OIG Okays Hospital's On-Call Coverage Compensation Arrangement
  • Proposed Settlement Will Expand Medicare's Coverage Rules for Chronic Conditions
  • OIG Approves Radiology Group's Proposal to Offer Free Insurance Preauthorization Services
  • OIG Releases 2013 Work Plan
  • OIG Okays Waiver of Cost-Sharing Amount Based on Determinations of Financial Need

 

Summer 2012
  • STATE LAW DEVELOPMENTS
    • New York Court Allows Hospital's Challenge of Recoupment Process after RAC Audit
    • New York Law Imposes New Rules for Administrative Denials of Emergency Hospital Admissions and Claim Coding Reassignments
    • New York Court Refuses to Dismiss Physician Lawsuit Citing Questions over "Control" by Hospital
    • OMIG Issues 2012-2013 Work Plan, Hospital Compliance Guidance and Compliance Alert Regarding Certification of Compliance Program
    • DOH Proposes Regulations to Implement Governor Cuomo's Executive Order on Executive Compensation
    • Mammogram Providers Will be Required to Notify Patients of Certain Mammogram Findings
  • FEDERAL DEVELOPMENTS
    • CMS Relaxes Its Controversial Rule Regarding Ordering and Referring Providers
    • HHS Proposes One-Year Delay of ICD-10 Compliance Date
    • CMS Eliminates 12-Month Look-Back Period for Medical Record Documentation
    • OIG Issues Negative Advisory Opinion on Ambulatory Surgery Center and Anesthesia Provider Arrangements
    • OIG Issues a Favorable Advisory Opinion on a Proposed Arrangement Between an IDTF and a Closely-Related Physician
    • FDA Issues Draft Guidance Regarding Transferring Clinical Investigation Oversight to Another Institutional Review Board (IRB)
 

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