Consistent with recently issued recommendations from The Centers for Disease Control (CDC) for social distancing during the COVID-19 emergency, on March 17, 2020, the Centers for Medicare & Medicaid Services (CMS) announced that, during the on-going public health crisis, it will permit Medicare providers to bill traditional Medicare (Medicare Parts A and B) for telemedicine services provided to Medicare beneficiaries. Until now, traditional Medicare only provided telehealth coverage for Medicare beneficiaries for certain limited services and only via communication from pre-approved locations.
The Department of Health and Human Services Office for Civil Rights (HHS-OCR) announced the Agency recovered an unprecedented $28.7 million from HIPAA enforcement activities in CY 2018. The HIPAA Privacy, Security, and Breach (HIPAA Rules) violations for which OCR was able to obtain either summary judgement or settlement payments involved some of the country’s top healthcare stakeholders; including MD Anderson ($4.3 million), Massachusetts General Hospital ($515,000), Fresenius Medical Care North America ($3.5 million), and Anthem, Inc. ($16 million).
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In late 2018, Congress enacted the Eliminating Kickbacks in Recovery Act (“EKRA”) as part of the larger effort to combat the national opioid addiction crisis. EKRA significantly expands the federal government’s regulation of transactions in healthcare by applying federal Anti-Kickback Statute (“AKS”) principles to select activities not involving federal health program reimbursement and exposing certain industry participants to sanctions they would face for engaging in conduct similar to that prohibited by the AKS.
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The Office of Civil Rights of the U.S. Department of Health and Human Services (the “OCR”) recently issued a Request for Information (the “Request”) to identify HIPAA Privacy, Security, & Breach Notification Regulations (“HIPAA Rules”) that hinder conversion of the payment system in the health care space to a value-based system or the coordination of care between Covered Entities and non-Covered Entities and yet do not significantly contribute to the safeguarding of Protected Health Information (“PHI”). The OCR seeks comment on HIPAA regulatory roadblocks and suggestions for eliminating them in several areas, including the following:
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Mori Hall, JD, LL.M., CHC, a Senior Associate in the Transactional and Regulatory Health
Law group, is an experienced attorney specializing in counseling healthcare stakeholders
in compliance, privacy, operational, and transactional regulatory matters in the healthcare
sector. Ms. Hall’s practice is focused on multifaceted regulatory issues that impact the
healthcare industry today, including:
Prior to joining Duggan Bertsch, Ms. Hall served as Privacy Counsel for a multi-national
reinsurer and human resources business process organization. Additionally, Mori has
worked for a big four consulting firm, advising the Centers for Medicare and Medicare
Services (CMS) and as in-house counsel for nationally renowned non-profit healthcare
Ms. Hall received a Bachelor of Arts in Political Science from Michigan State University.
She earned her Juris Doctorate from Michigan State University College of Law and a
Master of Laws (LL.M.) in Health Law from Loyola University Chicago School of Law.
Ms. Hall is admitted to practice law in Illinois and the District of Columbia. Mori is
Certified in Healthcare Compliance (CHC) by the Health Care Compliance Association
(HCCA). Ms. Hall is a member of the American Health Lawyers Association (AHLA), the
Illinois Association of Healthcare Attorneys (IAHA), the Health Care Compliance
Association (HCCA), and the International Association of Privacy Professionals (IAPP).
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