CMS Screening Protocols for Enrolling and Revalidating Providers Effective March 23

The Affordable Care Act of 2010 required the Centers for Medicare and Medicaid Services (CMS) to establish standards for screening Medicare, Medicaid, and CHIP providers, suppliers and eligible professionals based upon the level of risk associated with the category of provider.  CMS has identified three categories of risk—“limited,” “moderate” and “high”—and the type of providers, suppliers […]

BlueCross and BlueShield Pays $25 Million to Settle Medicaid Fraud Claims

On February 24, 2011, the United States Attorney for the Northern District of Illinois announced a $25 million settlement agreement with BlueCross and BlueShield of Illinois (BCBS) regarding alleged Medicaid fraud under the False Claims Act.  The government, according to the agreement, alleged that BCBS wrongfully terminated insurance coverage for private duty, skilled nursing  for children needing […]

Obama Administration Moves for Expedited Appeal of Florida Decision Nullifying Health Care Law

On March 9, 2011, in the ongoing litigation regarding the constitutionality of President Obama’s Health Care Law, known as the Patient Protection and Affordable Care Act (“PPACA”), the United States submitted to the Eleventh Circuit Court of Appeals a motion to expedite consideration of its appeal of a Florida federal district court’s decision, which struck down PPACA […]

NY Court of Appeals: Legislature Must Amend Penal Law to Include Health Care Insurance Fraud

In a recent New York State decision, the Court of Appeals held that New York Penal Law 170.60, insurance fraud in the first degree, does not necessarily encompass a fraudulent health care insurance act.  In People v. Boothe, decided on February 24, 2011, the defendant CEO of a managed health care provider was indicted on […]

April Deadline for Laboratories to Comply with N.Y. Prohibition on EHR Donations

The New York State Department of Health (DOH) announced that clinical laboratories operating in the state have until April 15, 2011 to comply with the state’s ban on donating electronic health record (EHR) systems to referring sources.  The formal statement that the state’s rules do not allow cost-sharing or donation of EHR systems came back […]

$4.3M Civil Monetary Penalty for HIPAA Privacy Violation

On February 22, HHS issued a Notice of Final Determination imposing a civil monetary penalty of $4.3 million against Cignet Health of Prince George’s County, Md., representing the first civil monetary penalty issued by the Department for a covered entity’s violations of the HIPAA Privacy Rule.  The HHS found that Cignet violated 41 patients’ rights […]

Second Circuit Issues Stay in Disability Advocates, Inc. v. Cuomo

On February 23, 2011, the Second Circuit Court of Appeals issued an order staying the Remedial Order and Judgment issued on March 1, 2010 by the U.S. District Court for the Eastern District of New York in Disability Advocates, Inc. v. Cuomo. The District Court’s Remedial Order directed the State of New York to offer […]

Second Circuit Issues Stay in Disability Advocates, Inc. v. Cuomo

On February 23, 2011, the Second Circuit Court of Appeals issued an order staying the Remedial Order and Judgment issued on March 1, 2010 by the U.S. District Court for the Eastern District of New York in Disability Advocates, Inc. v. Cuomo. The District Court’s Remedial Order directed the State of New York to offer […]

American Association of Bioanalysts’ Landmark Victory over New York State Department of Health Will Stand

On September 24, 2008, the Albany County Supreme Court issued a landmark ruling in favor of the American Association of Bioanalysts (AAB), represented by O’Connell and Aronowitz member Jeffrey J. Sherrin, against the New York State Department of Health (DOH).  AAB’s lawsuit alleged that the DOH’s Clinical Laboratory Evaluation Program was intentionally overcharging clinical laboratories […]

Introducing the Health Law Sidebar

Welcome to the Health Law Sidebar, the official blog of the O’Connell and Aronowitz Health Law Department. The Health Law Sidebar will provide you with the latest regulatory and statutory updates from the industry, and will also highlight news items of interest across the healthcare field. Thank you for your interest, and we hope you enjoy […]