December 16, 2022
In December 2020, Congress passed what is known as the No Surprises Act (NSA) in an effort to protect patients from surprise billing or unexpected fees. The Act prohibits out-of-network providers from “balance billing” patients for charges above the rates paid by their health plan if the provider is providing emergency services or is providing non-emergency services at an in-network facility.…
October 6, 2022
Telehealth is a growing trend in medicine. From 2019 to 2020, telehealth use increased an eye-popping 3000%, not including Medicaid and Medicare claims. Although the claims have decreased slightly as of 2021, telehealth is clearly here to stay and with it comes new challenges.
What is Telehealth?
For the purposes of Medicare, “telehealth services” are “professional consultations, office visits,…
August 3, 2022
Licensing boards provide consumer protection in the form of regulation, but do not provide compensation. Patients who claim harm from malpractice use the civil court system to seek compensation. Board complaints are sometimes used by claimants to further a malpractice claim. The potential of civil liability is an important consideration when handling a board action, highlighting the need for…
July 12, 2022
West Virginia’s Medical Professional Liability Act (MPLA), W. Va. Code 55-7B-6(b), provides that at least thirty days before filing suit, a claimant must serve two pre-suit documents - a Notice of Claim and a Certificate of Merit - on each health care provider they intend to sue. Timely compliance with the statute can “toll” or extend the applicable statute of limitations. In Adkins v. Clark, No.…
May 6, 2022
Beginning January 1, 2023, the Colorado Option Plan will go into effect. Under the Colorado Option Plan, private insurers will be required to offer a standardized insurance plan that offers certain health care services and dictates the services that insureds could receive without paying towards the deductible to the counties in which insurers already sell plans to the individual and small group…
March 18, 2022
Since January 31, 2020, the federal government has been operating with robust authority to combat the COVID-19 pandemic based on the U.S. Secretary of Health and Human Service’s ongoing declaration of a “public health emergency” (PHE) under 42 U.S.C 1395m(g)(1)(B). Telehealth services have been ubiquitous throughout the pandemic, and the expanded grant of legislative authority under the PHE have…
January 19, 2022
Congress enacted the No Surprises Act (the “Act”) to protect patients against “surprise bills,” while at the same time respecting a provider’s ability to receive remuneration for services rendered. To accomplish this, the Act creates an independent dispute resolution process (“IDR”), whereby the provider and insurance plan negotiate charges for an item or service in a manner similar to major…
April 21, 2021
The Substance Abuse and Mental Health Services Administration (“SAMHSA”) issued a statement on April 9, 2021 regarding 42 C.F.R. Part 2 (commonly referred to as “Part 2”). In its statement, SAMSHA asserted that it intends to publish amendments to the Part 2 regulations later this year, and affirmed that the current Part 2 regulations (including the…
October 16, 2019
In a recent resolution agreement between Elite Dental Associates (“Elite”), a dental practice in Dallas, Texas, and the U.S. Department of Health and Human Services Office for Civil Rights (“OCR”), the OCR alleged that Elite impermissibly disclosed patients' protected health information (“PHI”) in its responses to patient reviews on the social media site Yelp. As part of its investigation,…
June 24, 2015
The Kentucky Supreme Court rendered an opinion on June 11, 2015, establishing the law in Kentucky on ex parte communications with a party’s non-expert treating physician, i.e. interviewing the Plaintiff’s treating physicians in advance of a deposition. In Caldwell v. Hon. A.C. McKay Chauvin, the plaintiff in an underlying medical negligence action sought a writ from the Kentucky…
May 5, 2015
On April 20, 2015, the U.S. Department of Health and Human Services Office of Inspector General (“OIG”), in collaboration with the American Health Lawyers Association (“AHLA”), the Association of Healthcare Internal Auditors (“AHIA”) and the Health Care Compliance Association (“HCCA”) released new compliance guidance for health care boards entitled “Practical Guidance for Health Care Governing…
December 16, 2022
In December 2020, Congress passed what is known as the No Surprises Act (NSA) in an effort to protect patients from surprise billing or unexpected fees. The Act prohibits out-of-network providers from “balance billing” patients for charges above the rates paid by their health plan if the provider is providing emergency services or is providing non-emergency services at an in-network facility.…
October 6, 2022
Telehealth is a growing trend in medicine. From 2019 to 2020, telehealth use increased an eye-popping 3000%, not including Medicaid and Medicare claims. Although the claims have decreased slightly as of 2021, telehealth is clearly here to stay and with it comes new challenges.
What is Telehealth?
For the purposes of Medicare, “telehealth services” are “professional consultations, office visits,…
August 3, 2022
Licensing boards provide consumer protection in the form of regulation, but do not provide compensation. Patients who claim harm from malpractice use the civil court system to seek compensation. Board complaints are sometimes used by claimants to further a malpractice claim. The potential of civil liability is an important consideration when handling a board action, highlighting the need for…
July 12, 2022
West Virginia’s Medical Professional Liability Act (MPLA), W. Va. Code 55-7B-6(b), provides that at least thirty days before filing suit, a claimant must serve two pre-suit documents - a Notice of Claim and a Certificate of Merit - on each health care provider they intend to sue. Timely compliance with the statute can “toll” or extend the applicable statute of limitations. In Adkins v. Clark, No.…
May 6, 2022
Beginning January 1, 2023, the Colorado Option Plan will go into effect. Under the Colorado Option Plan, private insurers will be required to offer a standardized insurance plan that offers certain health care services and dictates the services that insureds could receive without paying towards the deductible to the counties in which insurers already sell plans to the individual and small group…
March 18, 2022
Since January 31, 2020, the federal government has been operating with robust authority to combat the COVID-19 pandemic based on the U.S. Secretary of Health and Human Service’s ongoing declaration of a “public health emergency” (PHE) under 42 U.S.C 1395m(g)(1)(B). Telehealth services have been ubiquitous throughout the pandemic, and the expanded grant of legislative authority under the PHE have…
January 19, 2022
Congress enacted the No Surprises Act (the “Act”) to protect patients against “surprise bills,” while at the same time respecting a provider’s ability to receive remuneration for services rendered. To accomplish this, the Act creates an independent dispute resolution process (“IDR”), whereby the provider and insurance plan negotiate charges for an item or service in a manner similar to major…
April 21, 2021
The Substance Abuse and Mental Health Services Administration (“SAMHSA”) issued a statement on April 9, 2021 regarding 42 C.F.R. Part 2 (commonly referred to as “Part 2”). In its statement, SAMSHA asserted that it intends to publish amendments to the Part 2 regulations later this year, and affirmed that the current Part 2 regulations (including the…
October 16, 2019
In a recent resolution agreement between Elite Dental Associates (“Elite”), a dental practice in Dallas, Texas, and the U.S. Department of Health and Human Services Office for Civil Rights (“OCR”), the OCR alleged that Elite impermissibly disclosed patients' protected health information (“PHI”) in its responses to patient reviews on the social media site Yelp. As part of its investigation,…
June 24, 2015
The Kentucky Supreme Court rendered an opinion on June 11, 2015, establishing the law in Kentucky on ex parte communications with a party’s non-expert treating physician, i.e. interviewing the Plaintiff’s treating physicians in advance of a deposition. In Caldwell v. Hon. A.C. McKay Chauvin, the plaintiff in an underlying medical negligence action sought a writ from the Kentucky…
May 5, 2015
On April 20, 2015, the U.S. Department of Health and Human Services Office of Inspector General (“OIG”), in collaboration with the American Health Lawyers Association (“AHLA”), the Association of Healthcare Internal Auditors (“AHIA”) and the Health Care Compliance Association (“HCCA”) released new compliance guidance for health care boards entitled “Practical Guidance for Health Care Governing…
