GW Wins Injunction Against United Healthcare; Connecticut Physicians Gain Reprieve in Medicare Advantage Termination Dispute

December 9, 2013

On December 5, 2013, Judge Stefan R. Underhill of the United States District Court, District of Connecticut issued a preliminary injunction against United Healthcare significantly hampering the insurer’s efforts to terminate over 2,000 Connecticut physicians as participating providers in United’s Medicare Advantage plans. New York clients Click Here to read entire Legal Alert. New Jersey …

New York State Office of the Medicaid Inspector General (“OMIG”) Issues Audit Protocol for Assisted Living Programs

December 4, 2013

OMIG published an audit protocol for assisted living programs (“ALPs”) on November 22, 2013 to take immediate effect. The protocol provides guidance for ALP providers in complying with certain requirements under the Medicaid program. OMIG uses the audit protocol during audits to determine if payments made should be disallowed. New York clients Click Here to …

Congressional Bill Proposes Further Limits on the In-Office Ancillary Services Exception Under the Federal “Stark” Law

September 17, 2013

The Federal “Stark” law limits the ability of physicians to offer certain services (commonly referred to as “Designated Health Services” or “DHS”) in their practice, unless an appropriate exception to the general prohibition is met. New York clients Click Here to read entire Legal Alert. New Jersey clients Click Here to read entire Legal Alert. …

New HITECH Regulations Enforced September 23, 2013

September 10, 2013

On September 23, 2013, the U.S. Department of Health and Human Services (“DHHS”) will begin to enforce the HITECH Omnibus Regulations, which made significant revisions to the privacy requirements of HIPAA. New York clients Click Here to read entire Legal Alert. New Jersey clients Click Here to read entire Legal Alert. Connecticut clients Click Here …

I-STOP Changes to Monitoring Program for Prescription Controlled Substances Take Effect August 27, 2013

August 19, 2013

The Internet System for Tracking Over-Prescribing Act (“I-STOP”) was signed into law last year by New York legislators to help reduce abuse of prescribed controlled substances. I-STOP has 5 different parts including: (i) overhauling New York’s prescription drug monitoring program to provide practitioners and pharmacists real-time prescribing data; (ii) mandating electronic prescribing for controlled substances, …