This month’s article from the Albany County Bar Association Newsletter discusses the New York Attorney General’s recent settlement with Excellus, a Rochester-based health insurer, which resulted from an investigation into complaints from consumers that Excellus was improperly denying claims for mental health and substance abuse treatment. The article also includes a brief overview of New […]
This month’s article from the Albany County Bar Association Newsletter offers brief summary of the recent decision in U.S. v. Patel, in which a physician was found to have violated the federal Anti-Kickback statute for an improper referral scheme with a home health agency, even though he did not actively divert patients to other providers. The […]
From the Albany County Bar Newsletter, February edition, available here.
The New York State Department of Health has posted draft regulations on the medical use of marijuana in New York. We’ll have more on these regulations in coming days. In the meantime, the interested should visit the DOH Medical Marijuana Website for the draft regulations, which run to 120 pages.
Take a look at our colleague, Michael Kogut’s take on FIDA in the American Health Lawyers Association’s LTC-SIR Advisor! AHLA LTC-SIR Advisor (11-14)
The Albany County Bar Association Newsletter includes an article written by our colleague, David Nardolillo, on a recent HIPAA-related decision from the Connecticut Supreme Court.
In what could be very important news this afternoon regarding the Patient Protection and Affordable Care Act (“PPACA,” or more commonly called “Obamacare”), the Supreme Court of the United States announced that it was granting certiorari in the case of King v. Burwell, decided on July 22, 2014, by the United States Court of Appeals […]
On Wednesday, October 2, the Centers for Medicare and Medicaid Services (“CMS”) issued its 2015 consultation guide for states to use when setting reimbursement rates with respect to any Medicaid managed care program subject to actuarial soundness requirements in 42 CFR 438.6 during rating periods starting January 1, 2015. The guide “describes information that CMS expects states to provide […]
The New York State Education Department (“SED”) issued a proposed rule to allow nurse practitioners (“NPs”) with 3,600 hours of experience to have collaborative agreements with hospitals, as opposed to individual physicians. We wrote about the amendment to the Education Law in April of this year. This first notice of proposed rulemaking appears to put […]
Office of the Inspector General of the federal Department of Health and Human Services (“OIG”) has issued a report that suggests that most states that offer Medicaid through Managed Care Organizations (“MCOs”) have widely-variable and possibly inadequate oversight of the organizations providing care to Medicaid beneficiaries. Given OIG’s findings, beneficiaries, providers, and Medicaid MCOs should […]