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Pharmacy Qui Tam Based On U&C Price Billing Survives Motion to Dismiss

January 15, 2015 | Blog | By Theresa Carnegie

Once again, a pharmacy employee has filed a qui tam involving a drug discount program, alleging that the failure of the pharmacy to use the discounted pricing as the “usual and customary” price in Medicaid and Medicare Part D billings resulted in falsely inflated claims to those programs.
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FCA Supreme Court Case to Watch For in 2015

January 15, 2015 | Blog | By Ryan Cuthbertson

The Supreme Court heard oral arguments on January 13, 2015 in a government contracts whistleblower case that could have a far-reaching impact on more than just federal contractors.
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New York Passes Telemedicine Reimbursement Legislation

January 15, 2015 | Blog | By Theresa Carnegie

New York became the 22nd state to sign into law legislation that will require commercial and Medicaid plans to provide coverage of telehealth and telemedicine services. The law, originally intended to take effect on January 1, 2015, will become effective on January 1, 2016.
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You’re Invited: Tips for Surviving a HIPAA Audit

January 15, 2015 | Blog | By Samantha Kingsbury

On Wednesday January 28th, my colleague Dianne Bourque (a member in Mintz Levin’s Health Law practice), will be presenting a webinar on how to survive a HIPAA audit.  As luck would have it, January 28th is also international Data Privacy Day.
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ML Strategies Posts Weekly Health Care Update on January 12, 2015

January 14, 2015 | Blog | By Ryan Cuthbertson

ML Strategies has posted its weekly Health Care Update. This publication provides timely information on implementation of the Affordable Care Act, Congressional initiatives affecting the health care industry, and federal and state health regulatory developments.
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Mintz Attorneys Discuss Top Health Care Fraud Issues to Watch in 2015

January 14, 2015 | Blog | By Brian Dunphy

Bloomberg BNA recently published a Health Care Fraud Report entitled Outlook 2015: Uptick Expected in Stark, Anti-Kickback FCA Cases, Self-Disclosures, which examines the top issues for health care providers and suppliers to watch in 2015.  
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New Year, New Breach Notification Laws

January 12, 2015 | Blog

As reported in a recent Privacy and Security Matters post, we have updated the “Mintz Matrix,” a summary of the U.S. state data breach notification laws. The Mintz Matrix is an invaluable tool for reviewing state breach notification requirements, which may apply in addition to HIPAA in the event of a data breach.
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Court Rules Antitrust Claim May Proceed Against Celgene

January 12, 2015 | Blog | By Dionne Lomax

On December 22, 2014, a federal district court in New Jersey found that Mylan Pharmaceuticals, Inc. (“Mylan”) alleged facts sufficient to plead an antitrust claim under Section 2 of the Sherman Act.
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OIG Provides Leeway for Copay Assistance to Low-Income Patients

January 9, 2015 | Blog | By Lauren Moldawer

Earlier this week the OIG released an advisory opinion stating that a nonprofit organization’s proposed arrangement to provide copayment assistance to financially needy patients would not result in civil monetary penalties or administrative sanctions, even though it could potentially generate prohibited remunerations under the anti-kickback statute.
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Mintz Advisory Analyzes the Upcoming Supreme Court Hearing in King v. Burwell

January 7, 2015 | Blog | By Lauren Moldawer, Andrew Shin, Stephen Weiner

The Supreme Court announced it will be hearing King v. Burwell – a case which could determine the future scope and reach of the Affordable Care Act (ACA) – on March 4, 2015. 
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A Guide to New York's Nonprofit Revitalization Act

January 7, 2015 | Blog | By Theresa Carnegie

The Nonprofit Revitalization Act brought sweeping changes to the laws that govern not-for-profit corporations in New York. Our colleagues Anthony E. Hubbard and Daniel E. Wilcox have authored an Advisory that provides an in-depth summary of key provisions of the Act that have recently gone into effect.
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States Doubling Down on Delivery and Payment Reform Efforts

December 22, 2014 | Blog

Although health care reform implementation via the Affordable Care Act (ACA) has focused mostly on federal changes to the health care marketplace, individual States are getting some much needed help to design and implement their own efforts to improve quality and lower health system costs.
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Office for Human Research Protections Extends Comment Period for Draft Guidance

December 22, 2014 | Blog

The Office for Human Research Protections (OHRP) is extending the comment period for its Draft Guidance on Disclosing Reasonably Foreseeable Risks in Research Evaluating Standards of Care (Draft Guidance).
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Registration Begins for American Telemedicine Association’s New Accreditation of Online Medical Services

December 19, 2014 | Blog

The American Telemedicine Association (ATA) is now accepting limited registrations for organizations that wish to gain ATA’s seal of approval for online medical services.
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CMS Issues Rewards and Incentive Guidance to MA Plans

December 18, 2014 | Blog | By Bridgette Keller

On December 4, 2014, CMS issued additional guidance regarding rewards and incentives programs (“RI Programs”). This guidance elaborates on whether an RI Program can target members with specific diseases, whether rewards can be tied to health outcomes, how to value rewards and incentives, and gives examples of appropriate and inappropriate rewards and incentives.
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FTC Centennial: How Health Care Antitrust Has Evolved

December 15, 2014 | Blog | By Dionne Lomax

This year the Federal Trade Commission ("FTC") celebrated its centennial. Looking back on the FTC’s first 100 years, we have seen dramatic shifts in antitrust enforcement in the health care sector. 
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HIPAA Settlement Continues to Emphasize the Importance of Security Policies and Procedures

December 9, 2014 | Blog

A recently announced settlement between Anchorage Community Mental Health (“ACMHS”) and the U.S. Department of Health & Human Services Office for Civil Rights (“OCR”) emphasizes, once again, the importance of compliance with the Security Rule and keeping IT infrastructure up to date.
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Provider Beware: HIPAA and State Privacy Laws May Inform Negligence Suits

December 9, 2014 | Blog

A recent opinion from the Connecticut Supreme Court illustrates that HIPAA is not the only law that covered entities and business associates must worry about if an unauthorized disclosure of protected health information (PHI) happens on their watch.
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Mintz Advisory Analyzes Medicare Shared Savings Program Proposed Rule

December 9, 2014 | Blog | By Karen Lovitch

On December 8th, the Centers for Medicare & Medicaid Services published its proposal for long-awaited changes to the Medicare Shared Savings Program (MSSP).  Our colleagues Daria Niewenhous, Andrew Shin, Lauren Moldawer *, and Stephanie Willis have authored an Advisory that provides an in-depth analysis of key provisions of the proposed changes and how they may impact current and future MSSP accountable care organizations created under the authority of the Affordable Care Act.
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After the Deal, is it Still Business as Usual?

December 8, 2014 | Blog | By Dionne Lomax

According to Federal Trade Commission Chairwoman Edith Ramirez, the healthcare sector will “remain a top agency priority.”  Thus, the FTC will undoubtedly continue to closely analyze combinations of providers in the industry. 
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