Showing 67 posts by Julie LaVille Hamlet.
New Legislation Makes Concierge Medicine a Viable Business Model In Michigan
The Affordable Care Act ("ACA") authorizes the innovative payment model referred to as direct primary care, and more commonly known as “concierge medicine.” Under the direct primary care model, patients can access comprehensive coverage of basic healthcare services for a flat monthly fee. Such services generally include guaranteed same-day or next-day visits with no waiting times. Concierge medicine is becoming increasingly popular in states where it is allowed. Read More ›
Categories: Billing/Payment, Health Care Reform, Insurance, Providers
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CMS Proposes Rule to Update Wage Index and Payment Rate for the Medicare Hospice Benefit
On April 30, 2015, the Centers for Medicare & Medicaid Services (“CMS”) issued a proposed rule that would update fiscal year (“FY”) 2016 Medicare payment rates and the wage index for hospices serving Medicare beneficiaries (the “Proposed Rule”). CMS estimates that the Proposed Rule would result in a 1.3 percent ($200 million) increase in hospice payments for FY 2016. The highlights of the Proposed Rule are summarized below. Read More ›
Categories: Billing/Payment, Medicare/Medicaid, News & Events
2015 Michigan Health Law Update
On March 12, 2015 Foster Swift Attorney Jennifer Van Regenmorter co-presented the Michigan Health Law Update (“Annual Update”) at the 21st Annual Health Law Institute. The Annual Update provides an overview of the most significant Michigan-specific health law developments from the past year, many of which have been covered on this blog. This article will summarize the highlights from this year’s Annual Update. Read More ›
Categories: Hospitals, Insurance, Licensing, Medicare/Medicaid, News & Events, Privacy
Recap from the 2015 Health Law Institute
Foster Swift health care attorneys recently attended and presented at the 21st Annual Health Law Institute on March 12 and 13, 2015. The two-day institute, which was co-sponsored by the Institute for Continuing Legal Education and the Health Care Law Section of the State Bar of Michigan, included presentations on recent statutory, regulatory, and case law developments in the health care industry.
Foster Swift Attorney Jennifer Van Regenmorter co-presented the “Michigan Health Law Update,” which provided an overview of Michigan’s most significant health law developments from the past year. This was Van Regenmorter’s third time presenting this yearly update at the Institute. Read More ›
Categories: Fraud & Abuse, HIPAA, News & Events, Physicians
Court Decertifies Class Action Suit against Henry Ford Health System for Data Breach
The Michigan Court of Appeals recently decertified a class action suit against Henry Ford Health System (HFHS) and its subcontractor, a medical transcription service, for inadvertently disclosing sensitive patient information online. On December 18, 2014, a unanimous three-judge panel reversed the trial court’s denial of summary judgment in favor of the defendants. The court held that an invasion of privacy claim requires an intentional act rather than mere negligence and that the plaintiff’s claims for negligence and breach of contract require proof of an actual injury.
The class consisted of 159 patients who visited HFHS between June 3, 2008 and July 18, 2008. The case arose when the defendant subcontractor made a configuration change to its server which left certain patient records unsecured. As a result, Google’s automated web server, “Googlebot,” indexed the information and made it available for users to search online. The information included each patient’s name, date of service, and diagnoses. The unnamed lead plaintiff alleged that her records revealed a sexually transmitted disease. Read More ›
Categories: Electronic Health Records, Privacy
Supreme Court to Weigh in on Providers’ Rights to Sue for Medicaid Reimbursements
The Medicaid program, a public insurance program serving approximately 66 million low-income Americans, is at risk for losing participating providers who claim they are not being compensated fairly for their services. On January 19, 2015, the Supreme Court heard arguments in Armstrong v. Exceptional Child Center, a case that could impact the rights of healthcare providers to sue states for higher Medicaid payments. Five private companies brought suit against the director of Idaho’s health department, arguing that the state unfairly reimbursed them at rates set in 2006, despite the fact that higher rates have since been approved by the Centers for Medicare and Medicaid Services (“CMS”).
Federal law provides that state Medicaid programs must ensure payments are “sufficient to enlist enough providers,” but states have discretion to decide what that means. 42 U.S.C. § 1396a(a)(30)(A) (the “Medicaid Statute”). Central to this case is whether providers have a cause of action that allows them to seek enforcement of a federal statute. Read More ›
Categories: Insurance, Medicare/Medicaid, Providers
And Then There Was One: Economic Pressures Squeeze Metro Detroit Hospitals into Consolidation
Reduced reimbursements. A shift toward global payment. A demand for integration, quality of care and medical specializations. In order to compete amidst today’s healthcare market pressures, independent hospitals in Michigan and around the nation are increasingly deciding that they cannot go it alone. A recent Detroit News article reveals how this trend is playing out in Metro Detroit, with one of the region’s last two independent hospitals poised for acquisition.
Observers of Detroit’s healthcare environment are reportedly not surprised by the news that Crittenton Hospital Medical Center has signed a letter of intent to join St. Louis-based Ascension Health, the largest Catholic and nonprofit health system in the nation. With Monroe-based Mercy Memorial Hospital announcing on January 6 that it is joining the ProMedica health care company, the Crittenton deal will leave Doctors’ Hospital in Pontiac as the region’s last remaining independent hospital.
Laura Wotruba, spokeswoman for the Michigan Health and Hospital Association, said that this is not a Michigan issue, but rather a widespread pattern. “[It is] a national trend [and] something we’ve been seeing around the country.” Read More ›
Categories: Electronic Health Records, Health Care Reform, HIPAA, HITECH Act, Hospitals, News & Events, Regulatory
"Right to Try" Becomes a Reality in Michigan
On Friday, October 17, Governor Rick Snyder signed the Right to Try Act, which allows patients to try experimental drugs and other treatments before they have been approved by the Food and Drug Administration (FDA). The law gives patients with advanced illnesses access to drugs that successfully cleared Phase 1 of an FDA approval. Phase 1 testing seeks to establish a drug's safety and profile and evaluates possible side effects. It involves 20-80 volunteers and lasts approximately one year. Read More ›
Categories: Hospitals, Insurance, Physicians, Providers
HHS Addresses Treatment of Same-Sex Spouses Under HIPAA
Last month, the U.S. Department of Health and Human Services (“HHS”) Office for Civil Rights (“OCR”) issued guidance addressing the treatment of same-sex spouses under the HIPAA Privacy Rule in light of the Supreme Court’s decision in United States v. Windsor.
In Windsor, the Supreme Court held Section 3 of the Defense of Marriage Act (“DOMA”) to be unconstitutional. Section 3 of DOMA had excluded same-sex marriages from recognition under federal law.
As a result of the Windsor ruling, legally married same-sex spouses are entitled to additional rights under several federal regulations, one of which is the HIPAA Privacy Rule ("Rule"). The Rule provides certain protections to family members of patients. In its guidance, OCR clarifies that legally married same-sex spouses are family members for the purposes of the Rule, regardless of where they live. Read More ›
OIG Proposes Revisions to Anti-Kickback Safe Harbors, Beneficiary Inducement Rules, and Gainsharing Regulations
On October 3, 2014, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) released a proposed rule to amend the safe harbors to the anti-kickback statute as well as the civil monetary penalty (CMP) rules. While much of the proposed rule codifies changes to the anti-kickback statute safe harbors already established by the Affordable Care Act (ACA) and Medicare Modernization Act of 2003 (MMA), it also proposes two new safe harbors and makes technical corrections to an existing safe harbor. The OIG also proposes to narrow the definition of "remuneration" in the Beneficiary Inducement CMP laws as well as codify and interpret the gainsharing CMP rules set forth in section 1128A(b) of the Social Security Act.
The proposed changes to the safe harbors and CMP laws would give providers greater flexibility to enter into beneficial arrangements with the assurance that they will not be subject to penalties under these laws. The proposed rule reflects the OIG's continued effort to adapt its regulations to the changing health care landscape.
For more details on these proposed changes, please visit our newsletter article, which provides an in-depth analysis of the proposed rule. If you have any questions on the proposed rule and how you are affected, please contact an attorney in our Health Care Practice Group.
Julie C. LaVille authored this article as a Law Clerk.
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Best Lawyers® 2021
Congratulations to the attorneys of the Health Care practice group at Foster Swift Collins & Smith, PC for their inclusion in the Best Lawyers in America 2021 edition. Firm-wide, 44 lawyers were listed. Best Lawyers lists are compiled based on an exhaustive peer-review evaluation and as lawyers are not required or allowed to pay a fee to be listed; inclusion in Best Lawyers is considered a singular honor. Health Care practice group members listed in Best Lawyers are as follows:
- Jennifer B. Van Regenmorter, Holland
To see the full list of Foster Swift attorneys listed in Best Lawyers 2021, click here.