By ROLF LOWE
In the past few months there have been two Federal District Court rulings addressing lawsuits brought in part on an alleged disclosure of Personally Identifiable Information (PII) and/or Protected Health Information (PHI) protected under the Health Insurance Portability and Accountability Act (HIPAA). In the rulings, the Courts have relied on a recent Supreme Court ruling on a case involving a class action lawsuit alleging violations of the Fair Credit Reporting Act (FCRA) issued in the spring of 2021.

The Supreme Court case, titled Ramirez v. TransUnion, arose out the named plaintiff, Sergio Ramirez, being placed on a list maintained by the Treasury’s Department’s Office of Foreign Assets Control (OFAC) [Read More]

By JEREMY BELANGER
On Oct. 24, 2018, the Eliminating Kickbacks in Recovery Act (EKRA) was enacted. Broadly speaking, EKRA prohibits soliciting, receiving, paying, or offering “any remuneration (including any kickback, bribe, or rebate) directly or indirectly, overtly or covertly, in cash or in kind,” for referring or to induce a referral to a recovery home, clinical treatment facility, or laboratory, as those terms are defined in EKRA. While modeled after the federal Anti-Kickback Statute, 42 U.S.C. § 1320a-7b(b), EKRA applies more broadly to any public or private plan or contract providing medical benefits, items, or services. EKRA is a criminal statute enforced by the U.S. Attorney General. A violation of EKRA [Read More]

Lansing Lines is presented in cooperation with MIRS, a Lansing-based news and information service.

MDHHS: Masks No Longer Needed At Schools, Indoors

Department of Health and Human Services officials announced that it is dropping the suggestion that masks be worn in schools or indoors as COVID-19 cases continue to fall.

The health department reported 4,271 new cases and 312 new deaths of COVID-19 over a two-day period this month. The two-day average of cases was 2,136, marking a decline in new cases across the state.

The report prompted the health department to revise guidance for wearing masks indoors to prevent the spread of the virus.

“This is good news for Michigan,” Gov. Gretchen Whitmer [Read More]

This story courtesy of MIRS, a Lansing-based news and information service.

The U.S. Supreme Court stopped the President Joe Biden administration’s vaccination-or-testing requirement on the nation’s largest employers.

The court allowed, however, the administration’s mandate for most health care workers at federally funded health care facilities to continue.

Chief Justice John G. Roberts Jr. and Justice Brett M. Kavanaugh were the only two justices in the majority on both orders while liberal Justices Stephen G. Breyer, Sonia Sotomayor and Elena Kagan would have allowed the workplace requirements to continue.

In the blistering dissent, the justices said, “When we are wise, we know not to displace the judgments of experts, acting within the sphere Congress marked out and under Presidential control, to deal with emergency conditions.

“Today [Read More]

By LAUREN WEBER & PHIL GALEWITZ
The surge driven by the extremely infectious omicron variant helped push the South Florida hospital with 206 licensed beds to 250 patients. The rise in cases came as the hospital struggled with severe staff shortages while nurses and other caregivers were out with COVID.

The challenge is finding room to safely treat all the COVID patients while keeping staffers and the rest of patients safe, said Dr. Scott Ross, chief medical officer.

“It’s not a PPE issue,” he said, referring to personal protective equipment like masks, “nor an oxygen issue, nor a ventilator issue. It’s a volume issue and making sure we have enough beds and caregivers [Read More]

By PAUL NATINSKY
Many recent articles appearing in mainstream conservative newspapers and magazines have bemoaned the unfair persecution of people who choose not to be vaccinated. Many authors find vindication in the shifting nature of virus variants, COVID’s growing footprint as an endemic virus and the highly contagious but less severe omicron variant currently dominating headlines.

What has been left out of many such reports are a few salient facts and included have been some curious policy rationales.

Case in point—The nation’s 17 million healthcare workers must be vaccinated, but not its 80 million workers as the Supreme Court split the baby of the latest federal bill on the subject. As increasing [Read More]

By EWA MATUSZEWSKI

A recent Wall Street Journal article was entitled “The New Trend in Healthcare – Do it Yourself.” My immediate reaction was, “Is this what we’ve come to as community of healthcare professionals – encouraging a DIY approach to primary care?” But reading the article, which had an excellent balance of what patients should and should not be doing on their own, made me realize we’ve been leading up to this point for years. After all, isn’t the patient-centered medical home a partnership model between patient and physician where we’ve encouraged patients to take control of their health? Now, through remote medical monitoring devices, over the counter tests, and [Read More]

By STEPHEN SHAVER & CHRISTIAN IERACI
Wachler & Associates P.C.

When a Medicare provider or supplier receives an overpayment demand that they believe is in error, the provider or supplier has a strategic and practical choice to make: let Medicare recoup the money while the appeal is pending or follow certain procedural steps to stop recoupment during the appeal. Either option may have unforeseen consequences and a new court case may offer some tools to providers and supplier caught in this situation.

A Medicare overpayment demand letter kickstarts the lengthy process of appeals and collection attempts, which can be costly and span several years. A demand letter will explain the reason for [Read More]

By CHRISTOPHER J. RYAN & GREGORY W. MOORE
Since last year, certain providers (e.g., anesthesiologists, radiologists, surgeons, etc.) in Michigan have had to navigate Michigan’s Surprise Medical Billing Law (Michigan Act). Starting Jan. 1, 2022, those same providers have also had to comply with the Federal No Surprises Act (Federal Act). Generally, both statutes prevent nonparticipating providers from balance billing patients when the patient’s insurance company pays less than the nonparticipating provider’s usual and customary charge. The Federal Act defines “nonparticipating providers” as those who do not have a contractual relationship with a plan/insurance company.

Although the two statutes largely apply to the same providers, those providers need to pay attention to [Read More]