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In December 2023, the U.S. Department of Health and Human Services (“HHS”) Office for Civil Rights (“OCR”) announced a $480,000 settlement with a Louisiana medical group following a phishing incident. In 2021, the medical group filed a breach report with HHS stating that a hacker – through a...
Take the time now to ensure your new job—and contract—will add to, not detract from, your quality of life.
On November 20, 2023, the U.S. Department of Health and Human Services (“HHS”) Office for Civil Rights (“OCR”) announced an $80,000 HIPAA settlement with Saint Joseph’s Medical Center (“SJMC”) in New York State. The settlement was the result of OCR’s investigation of SJMC after the Associated Press...
This month’s Friday Five explores a decision ordering an IME prior to a ruling on summary judgment motions, the extent claims reporting records can be sealed, the scope of ERISA preemption in the context of removal, and two decisions awarding summary judgment for the defendant despite the plaintiffs...
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”...
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...
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...
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...
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...