OCR Announces that the Phase 2 HIPAA Audit Program Has Already Started

The HHS Office for Civil Rights (OCR) just announced that its Phase 2 HIPAA audit program has started and that covered entities and business associates are already being contacted. You can find this announcement here. OCR has begun sending emails to verify contact information for various covered entities and business associates and determine which entities should be included in the audit pools. These emails from OCR will be sent from OSOCRAudit@hhs.gov and could be classified as spam or junk. OCR expects covered entities and business associates to check their junk or spam folders for communications from OCR and to respond. The message that OCR is currently disseminating, via email, looks like this.

ATTENTION ALCOHOLISM AND SUBSTANCE ABUSE SERVICES PROVIDERS: SAMHSA’s Proposed Changes to 42 CFR Part 2 Address Key Integration Issues, Raise Other Questions About Compliance Responsibilities

In an earlier post, we highlighted that the federal Substance Abuse and Mental Health Services Administration (“SAMHSA”) submitted a proposed rule for public comment in the February 9, 2016 edition of the Federal Register, see 81 FR 6988, proposing a number of changes to 42 CFR Part 2 (“Part 2”), the federal regulations governing the […]

N.Y. Appellate Division Upholds Insurance Policy Exclusion for “Five Guys” Data Breach

Today, the New York State Supreme Court, Appellate Division, Third Department issued a decision enforcing an insurer’s exclusion of coverage for “damages arising out of the loss of . . . electronic data,” stemming from a 2011 credit card data breach at certain locations of the Five Guys Burgers & Fries restaurant chain. The decision should prompt businesses, especially […]

Further Analysis of 60-day Medicare Overpayment Rule Reveals Emphasis on Proper Compliance Plans

Last week, we highlighted that the Centers for Medicare and Medicaid Services (“CMS”) released a long-awaited final rule regarding its interpretation of the statutory obligation of Medicare Part A and Part B providers to return any overpayments they receive from the program within 60 days after such an overpayment is “identified.”  The final rule is […]

CMS Releases Final Rule on 60-day Medicare Overpayment Reporting Obligations

This morning, the Centers for Medicare and Medicaid Services (“CMS”) made available a copy of a final rule clarifying the obligations of providers and suppliers to report and return Medicare overpayments within 60 days after the date on which the overpayment was identified.  The final rule will be published in tomorrow’s Federal Register.

O&A Offers Healthcare Payment Cycle and Financial Consulting for Challenging Markets

In the post-recession world of tighter credit, the close management of payment cycles, accounts receivable, payables, debt and financing obligations, and cash flow has become even more critical to maintaining healthy businesses. Management of these issues also impacts the successful start-up of new practices, facilities or acquisitions.  While these issues apply equally to healthcare market, […]

SAMHSA Submits Proposed Changes to 42 C.F.R. Part 2

Alcoholism, substance abuse and chemical dependency treatment providers should be aware that the Substance Abuse and Mental Health Services Administration (“SAMHSA”) has promulgated proposed changes to regulations regarding the privacy and confidentiality of what are now called “substance use disorder” treatment records.  Those privacy regulations, which are located at 42 C.F.R. Part 2, are well […]

Billing Agent for Healthcare Provider Settles for $500,000 to Resolve TRICARE False Claims Act Case

Today, the Department of Justice U.S. Attorney’s Office for the Northern District of New York announced a settlement with Medical Reimbursement Systems, Inc. (“MRSI”) to resolve allegations that it violated the false claims act.  The press release can be found here. Medical Reimbursement Systems, Inc. provided billing, coding and full revenue cycle services for health care […]

Comptroller: NYSDOH Leaves $95 Million of Drug Rebates on the Table

This week, the New York State Comptroller, Thomas P. DiNapoli, issued audit findings which claimed that the New York State Department of Health (“DOH”) failed to capture $95,100,000 in prescription drug rebates it was eligible to receive on drugs administered through the New York State fee-for-service program and the Medicaid Managed Care program from April […]