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HHS SETTLES WITH HEALTH PLAN ON PHOTOCOPIER BREACH

On August 14, the Department of Health and Human Services (HHS) announced that it had reached a $1.2 million settlement with Affinity Health Plan, Inc. (Affinity) to settle potential violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy and Security Rules. …
Read More Healthcare Update: HHS Settles with Health Plan on Photocopier Breach; FTC Allows Georgia Hospital Acquisition to Stand; HHS Awards $67 Million in Grants to “Navigators”

PROPOSED BILL WOULD ELIMINATE STARK LAW EXCEPTION FOR SOME SERVICES

The “Promoting Integrity in Medicare Act of 2013,” introduced in the U.S. House of Representatives on August 1, would eliminate one of the Stark Law’s exceptions for advanced imaging, anatomic pathology, radiation therapy and physical therapy services performed in a physician’s office. …
Read More Healthcare Update: Proposed Bill Would Eliminate Stark Law Exception for Some Services; Oregon Exchange Won’t be Completely Ready by Deadline; “Doc Fix” Bill Advances in House

HOUSE SUBCOMMITTEE APPROVES DRAFT OF PERMANENT “DOC FIX”

On July 23, the U.S. House of Representatives’ Energy and Commerce Health Subcommittee approved draft legislation that would reform Medicare’s much-criticized physician payment system. The legislation is scheduled to be considered by the full committee on July 31. The Energy and Commerce Committee posted a video on its website titled, “Bipartisan Voices to #FixSGR.” …
Read More Healthcare Update: House Subcommittee Approves Draft of Permanent “Doc Fix”; CMS Imposes Temporary Moratoria on Home Health Agencies and Ambulance Suppliers and Providers

WELLPOINT PAYS $1.7 MILLION FOR HIPAA BREACH

On July 11, the U.S. Department of Health and Human Services announced that health insurer Wellpoint Inc. has agreed to pay the sum of $1.7 million to settle claims that it violated the privacy and security rules under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). An improperly secured online database caused the electronic protected health information (ePHI) of 612,402 Wellpoint customers to be potentially vulnerable to unauthorized access, although the company said that it did not believe that any fraud or identity theft had occurred due to the breach.…

Read More Wellpoint Pays $1.7 Million for HIPAA Breach; CMS Announces Initial Pioneer ACO Results; CMS Releases Final Rule on “Navigators”

As reported in our Alert “IRS Proposes Rules on Fees Assessed on Health Plans to Fund Patient-Centered Outcomes Research Trust Fund”, the Patient Protection and Affordable Care Act (PPACA) imposed a fee on sponsors of group health plans that is intended to partially fund the Patient-Centered Outcomes Research Institute (PCORI). The PCORI fee is applicable to each plan year ending on or after October 1, 2012 and before October 1, 2019. …
Read More Sponsors of Self-insured Group Health Plans Must Pay PCORI Fees By July 31

The so-called “employer mandate” under the Affordable Care Act (ACA), requiring businesses to provide healthcare coverage to their employees or pay penalties, will be delayed for one year, until 2015. In a blog posting on July 2, Mark J. Mazur, assistant secretary for tax policy at the U.S. Department of the Treasury, said that the Administration had “heard concerns about the complexity of the requirements and the need for more time to implement them effectively” and would publish formal guidance on the transition within one week. …
Read More Federal Government to Delay Employer Mandate

The Supreme Court’s 5-4 ruling in Mutual Pharmaceutical Co. v. Bartlett, ___ U.S. ____ (June 24, 2013), offers welcome clarity to generic drug manufacturers: reaffirming that state tort claims against those manufacturers are preempted by the Hatch-Waxman Amendments to the Food, Drug and Cosmetic Act (“FDCA”), and by the Court’s landmark decision in Pliva v. Mensing, 113 S.Ct. 2567 (2011). …
Read More Mutual Pharmaceutical v. Bartlett: The Supreme Court Reaffirms Preemption of State-Law Claims Against Generic Drug Manufacturers

CMS UNVEILS WEBSITE AND CALL CENTER FOR EXCHANGES

On June 24, the Centers for Medicare & Medicaid Services (CMS) unveiled a revised HealthCare.gov website and a 24-hour-a-day consumer call center to provide information on the “Health Insurance Marketplace,” commonly referred to as state insurance exchanges. The exchanges, created under the Affordable Care Act, are to begin providing coverage on January 1, 2014. Open enrollment is scheduled to begin on October 1, 2013, notwithstanding widespread skepticism. …
Read More Healthcare Update: CMS Unveils Website and Call Center for Exchanges; CMS Releases Proposed Rule on Exchange Operation