Physician Law Blog

With the increasing strain on healthcare provider needs, the Department of Health and Human services announced on March 18th that as long as a healthcare provider holds an equivalent license from another state and are not affirmatively barred from practice in that state or any state that is included in the emergency area, they can provide care in any state.  This allows personnel and supplies to travel to where they are needed most to fight this epidemic.

Earlier this week, the University of Texas MD Anderson Cancer Center was ordered to pay a staggering $4,348,000.00 in order to resolve HIPAA violations from data breaches occurring in 2011, 2012, and 2013.The extremity of the penalties is explained by the fact that the data breaches were completely preventable. Generally, covered entities and business associates under the Health Insurance Portability and Accountability Act (HIPAA) are required to ensure confidentiality, integrity, and availability of all electronic protected health information (ePHI) that is created, received, maintained, or transmitted, and protect that information from reasonably anticipated threats and impermissible uses.

Ever wonder if the Office of Civil Rights (“OCR”) is serious about the requirements for a HIPAA Security risk analysis and policy specific to removing hardware and electronic media containing ePHI from a covered entity’s facility? Yes, the OCR is extremely serious about those requirements as Cancer Care Group, P.C. (“Cancer Care”), a radiation oncology private practice, with 13 radiation oncologists discovered after reporting a breach of ePHI.

The Affordable Care Act (PPACA) expanded the False Claims Act (FCA) to require providers to report and return any overpayment within 60 days of identification. Just what “identification” means under this rule has been unclear until now. With the SDNY’s recent ruling in Kane v. Healthfirst, Inc., No. 1:11-cv-02325-ER (SDNY Aug. 3, 2015), there is now guidance. The Kane decision, a whistleblower/false claims case, clarifies what constitutes “identification” for purposes of triggering FCA liability related to the 60 day rule to report overpayments.