Labeling Medicare a “rigged system,” President Trump has outlined a plan that he believes would allow it to lower drug prices covered under its Part B coverage. Specifically, the proposal would permit Medicare to implement a new reimbursement scheme that would reduce drug prices to achieve parity with costs in other nations.» Read More

In New Jersey, a physician is required to maintain treatment records for seven years from the date of the most recent entry; however, questions always arise about how long a physician must retain medical records for a minor.

The State Board of Medical Examiners does not differentiate between minor and adult patients, and simply sets a seven-year retention requirement. » Read More

As most physician practices move towards implementing EHR systems and technologies, medical offices are often prompted to decide whether or not to dispose of old medical records for inactive patients. The question of how long a physician must maintain patient medical records depends on a variety of business and legal factors, as outlined below.» Read More

The developers of EPIC Systems, the electronic health records software systems used by numerous hospitals, have not figured out how to handle daylight savings time changes, even after years in operation and multiple daylight savings time changes.  The software can delete records and requires cumbersome work arounds for health information entered between 1 a.m.» Read More

There is no doubt that the current administration is pushing to expand the Medical Marijuana Program (MMP) in New Jersey.  Since Gov. Murphy took office this year, the number of patients registered has doubled.  The addition of five qualifying debilitating conditions and medical marijuana being viewed as a means to combat the opioid epidemic, are two of the reasons for the drastic increase in patient numbers. » Read More

In a recent case, Filefax, a medical record storage, maintenance, and delivery company, paid the US Department of Health and Human Services, Office of Civil Rights (“OCR”) $100,000 to settle claims of HIPAA violations even after the company went out of business. » Read More

As many of you are aware, the New York State Department of Financial Services (“DFS”) approved the conversion, demutualization, and sale of MLMIC to National Indemnity Company, a member of the Berkshire Hathaway Group.  The Cash Consideration of the transaction is $2,502,000,000 which is to be distributed to certain MLMIC policyholders (individual, employed, physicians) or their designees. » Read More

According to the Office of Inspector General (OIG), the government’s primary civil tool for addressing health care fraud is the False Claims Act (FCA).  Most FCA cases are resolved through settlement agreements in which the government alleges fraudulent conduct and the settling parties do not admit liability. » Read More

The Out-of-Network Consumer Protection Transparency Cost Containment and Accountability Act was adopted in June 2018 and went into effect last month.  It has gotten significant attention regarding emergent or urgent services rendered to patients, and the inability of out-of-network providers and facilities to balance bill the patient. » Read More

Space sharing and co-location arrangements have been popular service delivery models for hospitals and independent physician practices.  These arrangements enhance patient convenience, improve continuity of care and present cost sharing benefits to the parties involved.  However, Medicare rules related to hospital provider-based department status and the Pennsylvania Department of Health (DOH) Guidance Regarding Hospital Outpatient Department – Shared Space arrangements have severely limited what space sharing arrangements will continue to qualify under Medicare’s Hospital Outpatient Department (HOPD) billing rules.» Read More