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In early November, the U.S. Department of Health and Human Services (“HHS”) Office of Inspector General (“OIG”) released its General Compliance Program Guidance (the Guidance). This was HHS OIG’s first update since 2008. What You Need to Know: This is the first compliance compendium released by HHS...
On Halloween, the U.S. Department of Health and Human Services (HHS), Office for Civil Rights (OCR) announced a $100,000 settlement under the Health Insurance Portability and Accountability Act (HIPAA) with Doctors’ Management Services (DMS), a Massachusetts medical management company that provides...
This month’s Friday Five covers cases relating to petitions for attorneys’ fees, unpersuasive self-reported evidence of disability, and a dilatory attempt to augment the administrative record. The Saul Ewing Employee Benefits/ERISA Litigation Team Western District of Wisconsin Slashes “Eye-Popping”...
Saul Ewing's Construction Group is hosting a complimentary half-day symposium discussing hot topics in the industry. The morning will begin with a presentation by our keynote speaker, Dana Peterson, Chief Economist of The Conference Board, who will discuss the current state of the economy and a...
Jim Gkonos will be speaking at the 2023 Insurance Forum on November 2, 2023. Location: In Person Only, Offices of Locke Lord LLP 111 S. Wacker Drive, 41st Floor, Chicago, IL, 60606 8:00 AM - 2:30 PM Speakers Include: Welcome and Introduction Kenneth M. Weine – Chief Audit Officer, American...
In October 2023, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) published Advisory Opinion 23-07 and approved a plan by a multi-specialty physician practice to pay its employed physicians bonuses related to net profits derived from outpatient procedures...
Florida’s lien law is once again under construction with significant changes which went into effect on October 1, 2023. The amendments impact various aspects of lien rights, notice requirements, bond amounts, and attorney fee recovery. Key Provisions and Implications Lien Rights Extended to...
This month’s Friday Five explores recent decisions that range from the effect on disability benefits when medical records are not provided after two appeals, to a case that examines how an award of death benefits is determined, to a finding that an insurer’s decision to terminate benefits was not...
Jim Goodrich will moderate a panel called “Following the Money in a Construction Project” during the 2023 HEREL Annual Conference at University of Minnesota. This session will address several money-related topics that arise over the course of a project such as allowances, contingencies, savings, and...
On September 11, 2023, the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) announced a settlement with LA Care related to potential violations of Health Insurance Portability and Accountability Act (HIPAA). LA Care is the largest publicly operated health plan in the...
Throughout 2023, OSHA has implemented multiple policy changes meant to enhance its enforcement mechanisms, including increased funding and inspector hirings, revisions to the "instance-by-instance" violation policy, modifications to the Severe Violator Enforcement Program, and the new electronic...
In late August, the HHS Office for Civil Rights ("OCR") announced an $80,000 settlement with United Healthcare Insurance Company ("United") relating to OCR's right of access initiative (the "Initiative") which requires that patients be able to access their health information in a timely manner...
This month’s Friday Five explores decisions regarding the timeliness of appeals, the support necessary to sustain an LTD termination decision, a court’s discretion to credit and discredit expert opinions, the circumstances under which an insured may be required to prove they were prejudiced by the...
The HHS Office of Inspector General issued an 'unfavorable' advisory opinion in August with respect to a proposed joint venture relating to interoperative neuro monitoring. Parties considering joint ventures and those in joint ventures should review the OIG analysis to assess compliance with...
The Nuts and Bolts of Locums An introductory webinar on getting started in the independent practice of emergency medicine, including a discussion on five important details that are often missed when negotiating a locums contract: What is the “bill rate” for the client? What is the margin for the...
This month’s Friday Five addresses two cases involving disability claims that touch on Covid-19, a Circuit Court ruling for an insurer, a district court ruling that a 20-year-old regulatory settlement precluded an insurer from relying on the opinions of physicians it hired, and a claim for breach of...