By March 2, 2022, HIPAA covered entities (healthcare providers, health plans, and healthcare clearinghouses) must report all 2021 breaches of unsecured PHI that affected fewer than 500 individuals to the Office for Civil Right for the U.S. Department of Health & Human Services (OCR).  Covered entities must submit these reports through the HHS web portal,

Winstead Shareholders Katy Carmical, Corinne Smith and Kevin Wood recently discussed Medical Timeshares in a new American Health Law Association article.

The article can be read here: Medical Timeshares Require More Than What You Learned in Kindergarten

Last week, the Wall Street Journal (WSJ) reported on investigations and audits by several states into the contractual relationships with pharmacy benefit managers, also known as PBMs. As noted in the article, state Medicaid programs are taking a closer look at their PBM contractors’ compliance practices, both contract and regulatory, to determine whether the

Winstead Shareholders Corinne Smith and Kevin Wood hosted a webinar on Wednesday, May 5 at 3:00 p.m.

Most hospitals and health systems, regardless of size, are planning to increase their investments in ambulatory surgery centers (ASCs). ASCs have become the model for providing high-quality, low-cost surgical care, and many hospitals are converting their outpatient departments

There’s no such thing as a free lunch….  This adage is over 50 years old, and the Office of Inspector General for Health & Human Services (OIG) wants to remind doctors that it remains true.

The pharmaceutical and medical device industry continues to woo doctors with invitations to educational speaker programs in high-end restaurants, with golf excursions, or at sporting venues.  On Monday, November 16, the OIG issued a new Special Fraud Alert to remind doctors that speaker programs sponsored by pharmaceutical and medical device companies must serve a legitimate educational purpose and must be appropriately tailored to meet a need in the medical community.

The Open Payments Act requires pharmaceutical and medical device companies to report their spending on entertainment.  According to Open Payments data, cumulative doctor payments in the three years from 2017-2019 exceeded $2 billion, and the OIG emphasized that this high amount of spending, and its potential to influence the prescribing or ordering habits of targeted physicians, was one of the reasons for this new alert.

Continue Reading There’s No Such Thing as a Free Lunch

Among the multitude of relief options under the CARES Act, the U.S. Department of Health & Human Services (HHS) allocated provider relief funds (PRF) to healthcare providers.  Phase I in late April saw healthcare providers receive $50 billion in general PRF distributions, largely based on historical Medicare volume or net revenues.  Phase II followed in early May with general PRF distributions of $15 billion for Medicaid, Children’s Health Insurance Program (CHIP), and dental providers.  And continuing after that, HHS issued some $52 billion in targeted PRF distributions among: (1) hospitals treating large numbers of COVID-19 patients; (2) rural providers; (3) skilled nursing facilities; (4) safety net hospitals; and (5) tribal healthcare providers.  All in all, HHS issued $175 billion in PRF to support healthcare providers.

Continue Reading If You Received Provider Relief Funds Under the CARES Act, Are You Preparing Adequate Support for Your Use of the Funds?

On August 4, 2020, the Office of Inspector General of Health & Human Services (OIG) used a new website resource to share informal guidance on the ability of laboratories to provide free COVID-19 antibody testing to Medicare beneficiaries.  For the specific situation, the requestors indicated that the clinical lab would provide free COVID-19 antibody testing to patients—including federal healthcare program beneficiaries—in conjunction with other medically necessary blood tests performed by the lab.  The lab indicated that it would not charge any patient or other payors for the COVID-19 antibody tests offered in conjunction with other paid lab tests.  The requestors also indicated that the purpose of the arrangement had a public health focus as it was intended to increase patient awareness of antibodies to promote donations of COVID-19 blood plasma, which can be used for certain experimental convalescent plasma therapy treatments for COVID-19.

Continue Reading OIG Approves Free COVID-19 Antibody Testing for Medicare Beneficiaries

The past few years have seen an unprecedented number of bankruptcies in the healthcare space, primarily from hospitals and senior living operators.  The pressure placed on healthcare operating companies will only increase as they deal with the effects of the COVID-19 pandemic and continued downward pressure on reimbursements.  As the owner of the real estate