The U.S. Department of Health and Human Services (“HHS”) Office for Civil Rights, in coordination with the Substance Abuse and Mental Health Services Administration, recently released a Final Rule which modifies the Confidentiality of Substance Use Disorder (“SUD”) Patient Records regulations located at 42 C.F.R. Part 2 (commonly known as “Part 2”)[1]. The statute upon which Part 2 relies, 42…
West Virginia’s Medical Professional Liability Act (“MPLA”), W. Va. Code § 55-7B-1, et seq., implements tort reform in medical malpractice actions. Pursuant to the MPLA, plaintiffs must serve two documents, a Notice of Claim and Screening Certificate of Merit, on each health care provider they intend to sue at least thirty days prior to filing a medical professional liability action.[1] The…
On July 3, 2023, the Office of the Inspector General (OIG) and the U.S. Department of Health and Human Services (HHS) published a final rule implementing information blocking penalties against two types of health care actors—health information networks (HINs)/health information exchanges (HIEs) and developers and offerors of health information technology (HIT).[1] The final rule became effective…
On June 16, 2023, the United States Supreme Court handed down its decision in U.S. ex rel. Polansky v. Executive Health Resources, No. 21-1052. The decision may have a lasting impact on the quickly growing False Claims Act (“FCA”) qui tam litigation throughout the United States.
In Polansky, the Supreme Court held that the federal government has the authority to dismiss an FCA suit in which it…
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,…
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…
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.…
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…
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…
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…
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…
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,…