Author Archive

Oklahoma DHS Acknowledges Inappropriate Disclosure of Files

While Oklahoma may be a world away from New Jersey, the headline I read during my recent visit to Oklahoma reminded me that agencies and practices in every state struggle with safeguarding confidential patient health information. As reported by the Oklahoman, a used furniture store in Oklahoma City recently sold a surplus file cabinet to

Broad-based Coalition Demands Immediate Passage of Healthcare IT Legislation

Earlier today, Health IT Now!, a coalition of more than 175 businesses, non-profit and patient groups, urged Congress to “pass federal legislation that promotes the widespread adoption of health information technology in the remaining weeks before Congress adjourns.” In particular, Health IT Now!’s September 9th letter to Congress asks Congress to adopt legislation that includes

Legislators and Researchers Question Direct-to-Consumer Ads

As we have discussed in prior blogs, state lawmakers throughout the country are debating increased restrictions on the pharmaceutical industry’s ability to promote its pharmaceutical products to physicians. The industry has voluntarily responded by adopting various rules, including capping the amount of money that pharmaceutical representatives can spend promoting drugs to healthcare providers. Pharmaceutical industry

Payer Acknowledges Improper Out-of-Network Reimbursements

New Jersey patients and providers recently enjoyed a victory in their long-running tug-of-war with payers concerning the reasonableness of out-of-network reimbursements. Last Tuesday, the New Jersey Department of Banking and Insurance (“DOBI”) announced that Healthnet of New Jersey has agreed to pay $41 million to settle charges that it systematically underpaid out-of-network providers between 1996

New California Law Subjects Providers to Steep Fines for Privacy Breaches

Under a bill recently approved by the Assembly and expected to be signed into law, California Healthcare providers could soon be subject to hefty fines and costly civil litigation if they fail to adopt and implement “appropriate administrative, technical, and physical safeguards to protect the privacy of a patient’s medical information.” While A.B. 211 appears

North Carolina to Publish Data Regarding “Confidential” Med Mal Settlements

Under a new North Carolina regulation, details regarding North Carolina medical malpractice settlements will soon be posted online for patients to view. Confidential out-of-court settlements have long been the option of choice for medical malpractice defendants in North Carolina and elsewhere. However, if the North Carolina Board of Medical Examiners gets its way, North Carolina

E-Prescribing Could Save Thousands of Lives Each Year

Regular readers of this blog will recall our recent discussion concerning the new ‘carrot’ of a 2% bonus that is being offered to electronic prescribers by the Centers for Medicare and Medicaid Services (“CMS”). Perhaps you will also recall our blog regarding the Drug Enforcement Agency’s (“DEA”) efforts to make E-prescribing more attractive by eliminating

HHS Proposed Rule Causes Controversy

Yesterday’s blog discussed the background of HHS’ proposed rule, which would penalize institutions that discriminate against providers who refuse to refer patients to abortion providers. As promised, today we’ll focus on the details of the proposed rule, which is entitled “Ensuring that Department of Health and Human Services Funds Do Not Support Coercive or Discriminatory

HHS and ACOG Battle Over OB/GYN Conscience Rights

In a controversial move, last Thursday, HHS proposed regulations that would prevent healthcare providers from being compelled to refer patients to abortion providers if doing so would violate the provider’s conscience. Before diving into the proposed rule, let’s quickly consider the history of this issue. ACOG Opinion On November 7, 2007, the American College of

After years of Litigation, E/M Denials Persist

Notwithstanding years of litigation and multi-million dollar settlements, many healthcare providers continue to experience inappropriate evaluation and management service (“E/M”) denials. Earlier today, I spoke with a provider who had a well-founded complaint regarding his denials, so I want to take a minute to quickly review the basics. E/M is a visit or consultation provided