New York Legislature Passes Certificate of Need Reform Bill

On Friday, June 17, 2011, the New York State Assembly approved the Certificate of Need (“CON”) reform bill (A7665B), which already passed the Senate two weeks ago. The bill now rests on Governor Cuomo’s desk for signature. The CON reform bill eliminates the requirement for prior approval of many categories of facility repair and maintenance construction projects, […]

New York Legislature Amends Family Health Care Decisions Act to Include Surrogate Decision-Making about Hospice Care

On June 20, 2011, the New York State Senate passed S.5259A (Hannon), a companion bill to A.7343A (Gottfried), which had previously passed the Assembly on June 17, 2011.  These bills amend the Family Health Care Decisions Act (FHCDA) to authorize surrogate decision-making regarding hospice care, regardless of whether the patient is in a hospital or nursing […]

Federal Decision Shows Inability to Rely upon CMS Approval

A recent decision by the U.S. District Court for the Middle District of Tennessee has significant implications on provider arrangements structured in reliance on the knowledge and approval of the Centers for Medicare and Medicaid Services (CMS). In U.S. ex rel. Williams v. Renal Care Group, the court analyzed the corporate structure between RCG Supply Company […]

New York State Department of Health Begins Accepting Applications for Managed Long-Term Care Providers

On Tuesday, June 14, 2011, the New York State Department of Health (DOH) launched part of Governor Andrew Cuomo’s Managed Long-Term Care Plans (MLTCP) and announced that it is now accepting applications from eligible organizations, pursuant to Article 4403-F of the Public Health Law.  This initiative seeks to redesign New York’s Medicaid system in ways that […]

Medicaid Fraud: Grand Larceny or Is Another Doctor Just Getting Played?

The recent June 3, 2011 indictment of Suresh Hemrajani, a Washington Heights doctor, by the Manhattan District Attorney’s Office, at first glance appears to be simply another Medicaid doctor accused of stealing $700,000 from Medicaid by billing and writing expensive human immunodeficiency virus (HIV) prescriptions for “patients” who did not actually have AIDS.  A closer […]

Progress Report Outlines Accomplishments of Medicaid Redesign Team

Governor Cuomo recently released a progress report outlining his Medicaid Redesign Team’s accomplishments to date.  Governor Cuomo created the Medicaid Redesign Team in January 2011 “to reduce costs and increase quality and efficiency” in New York’s Medicaid program.  New York spends more than $53 billion each year on Medicaid.

Gov. Cuomo Submits Health Benefit Exchange Bill to Rival NY Senate Majority Bill

New York State Governor Andrew Cuomo submitted a Governor’s program bill yesterday, June 13, 2011, proposing legislation that would comply with the requirements of the Federal Patient Protection and Affordable Care Act (PPACA) to create a Health Benefit Exchange.  The exchange, once established, will be a statewide “marketplace” through which individuals and small business who do not have […]

Vermont Establishes Single Payer System

On May 26, 2011, Vermont Governor, Peter Shumlin, signed a bill that will establish a statewide publicly funded single-payer health care system.  The bill will create a “universal and unified health system” called “Green Mountain Care” and all of the state’s residents will be eligible for coverage. The Governor issued a written statement announcing the […]

HHS Releases HIPAA Privacy Rule Accounting of Disclosures

The Department of Health and Human Services (HHS) issued its notice of proposed rulemaking to modify the HIPAA Privacy Rule’s standard for accounting of disclosures of protected health information (PHI). The current accounting provision applies to disclosures of paper and electronic PHI, regardless of whether such information is in a designated record set (DRS), for […]

First Meeting of the Public Health and Health Planning Council

The Public Health and Health Planning Council, whose first meeting scheduled for June 2 never took place, has rescheduled its first business meeting for tomorrow, Thursday, June 9, 2011.  At this meeting, the PHHPC is expected to adopt bylaws, elect the Vice Chair, populate its Committees, adopt a 2011 calendar, and adopt guidelines for the […]