Most health care providers are familiar with the concept of a “credit balance”. A credit balance can occur when a health care provider is overpaid for a service that was provided. Sometimes the credit balance can occur when a patient or the patient’s third-party insurer pays too much for the service provided. Other times a credit balance may occur when there is more than one insurer and both insurers pay for the same service. For a variety of innocent reasons credit balances are not uncommon in a health care practice.Continue Reading Credit Balances – It’s Not Yours to Keep
In August, 2017, the Centers for Medicare & Medicaid Services (“CMS”) announced a major change in how it will approach the selection of Medicare claims for improper payment review.Continue Reading Centers for Medicare and Medicaid Services Announces Transition to Targeted Probe and Educate Strategy
On Monday, June 26, 2017, the U.S. Supreme Court issued a decision on the two infamous “Travel Ban” cases, each of which involve challenges to President Trump’s Executive Order No. 13780, Protecting the Nation From Foreign Terrorists Entry into the United States.Continue Reading IMMIGRATION NEWS FLASH: U.S. Supreme Court Lifts Injunction on President Trump’s Travel Ban 2.0, Executive Order 13780
On May 8, 2017, the Eleventh Circuit Court of Appeals issued its opinion in the case of Silva v. Baptist Health South Florida, Inc. This decision is of importance to the health care industry as it establishes the standard under Title III of the Americans with Disabilities Act, 42 U.S.C. §§ 12181-12189 (“ADA”) and Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. § 794 (“Rehab Act”) for the sufficiency of communication with hearing impaired persons in conjunction with the provision of medical services.Continue Reading Effective Communication With Hearing Impaired Persons in Conjunction With the Provision of Medical Services – Silva v. Baptist Health South Florida, Inc.
In a statement released on April 24, 2017, the U.S. Department of Health and Human Services, Office of Civil Rights (OCR), has shown once again the level of expectations that exist for covered entities and business associates. As discussed below, OCR has shown that it will not just limit its review to a particular alleged violation of the HIPAA Privacy and Security Rules but rather will take an enterprise wide view of the compliance efforts of covered entities and business associates.Continue Reading HIPAA Policies and Procedures – Make sure they are in final form.
In a statement released on April 12, 2017, the U.S. Department of Health and Human Services, Office of Civil Rights (OCR), has shown that it expects covered entities of all sizes to adhere to the HIPAA privacy and security rules. While many of the fines levied by OCR in the past have involved large covered entities such as hospitals and health plans, OCR’s most recent enforcement action resulted in a $400,000 settlement to be paid by a federally qualified health center in Colorado.Continue Reading HIPAA Fines – Not Just for Hospitals and Health Insurers
On March 22, 2017, the Supreme Court of the United States issued a much-anticipated opinion regarding the appropriate standard to be used to determine whether a free appropriate public education (“FAPE”) has been provided under the Individuals with Disabilities Education Act (20 U.S.C. §1400, et. seq.). This decision is of extreme importance to both school districts and the parents of children with disabilities, as it will significantly impact the provision of special education and related services to children with disabilities.Continue Reading The Individuals with Disabilities Education Act – Endrew F. v. Douglas County School District
The Third Circuit Court of Appeals recently decided a case brought against a private hospital by a female participant in the hospital’s medical residency program that may have important implications for residency programs. The plaintiff alleged that the hospital was liable under Title IX of the Education Amendments Act of 1972 for creating a hostile work environment, retaliation, and quid pro quo harassment, along with several state-law claims. The plaintiff claimed that the director of her radiology residency program sexually harassed her over the course of several months. After she complained about the director’s behavior, she was dismissed from the residency program.Continue Reading Court Determines Title IX Applies to Residency Program at a Private Hospital
Immigration is one of President Trump’s signature issues that he campaigned on in the 2016 election. In attempting to fulfill his campaign promises, during his first week in office, President Trump issued three (3) Executive Orders. It is the 3rd Executive Order that is currently having the greatest impact on affected foreign national employees in the workplace.Continue Reading IMMIGRATION NEWS FLASH: President Trump’s Executive Orders: What Employers Need to Know
On January 31, 2017, the Supreme Court of Florida issued an opinion regarding the interplay of Amendment 7 (Art. X, § 25, Fla. Const.) and the Federal Patient Safety and Quality Improvement Act (42 U.S.C. §§ 299b-21 to 26) (“FPSQIA”). This decision is of extreme importance to the health care industry in Florida as it will significantly impact the peer review activities of hospitals and other health care providers within the state. Continue Reading Amendment 7 and the Federal Patient Safety and Quality Improvement Act – Charles v. Southern Baptist Hospital of Florida, Inc.