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Second Tuomey Trial Starts Today

Opening arguments begin today in the second trial in a lawsuit filed by a whistleblower-physician against Tuomey Healthcare System, Inc. (Tuomey). The United States intervened in the matter which alleges that Tuomey entered into part-time employment agreements with 19 physicians that violated the Stark law resulting in False Claims Act (FCA) liability for Tuomey because as the government alleges, that Tuomey took into takes into account the revenue it expected to receive from physicians’ referrals to value the physicians’ base compensation.

Proposed Rules Would Extend and Modify EHR Donation Stark Exception and Anti-kickback Safe Harbor

The Stark exception and the Anti-kickback safe harbor that protect electronic health record (EHR) donation to physicians are both set to expire on December 31, 2013. This week, in response to this looming deadline, the Centers for Medicare & Medicaid Services (CMS) introduced a rule that would extend the Stark exception to December 31, 2016. Also this week, the Department of Health and Human Services Office of Inspector General (OIG) introduced a proposed rule extending the Anti-kickback safe harbor to December 31, 2016.

CMS Rule Change Affects Incorrect Medicare Part A Payments

CMS issued a new rule on March 13, 2013, allowing providers to be paid for services billed under Medicare Part A, which should have been billed under Part B. However, a notice of proposed rulemaking issued the same day states that those claims must still be submitted within a strict one-year window that renders the new rule ineffective.

Health Care Information Alliance Formed

McKesson Corp., Allscripts, athenahealth Inc., Greenway Medical Technologies Inc., RelayHealth, and Cerner announced at the 2013 Healthcare Information and Management Systems Society annual meeting in New Orleans that they have banded together to form an independent trade association.

Universities, Hospitals, and Related Institutions Subject to Revised Final EPA “Area Source” Boiler Air Rules

On December 20, 2012, EPA finalized its “area source” boiler regulations designed to limit air emissions from small- to medium-sized boilers that burn coal, oil, or biomass which serve as the source of heat and sometimes power at a variety of commercial businesses, such as hotels and office buildings, as well as institutional entities, including universities, schools, education centers, medical centers, hospitals, municipal buildings, and prisons. According to EPA, 183,000 boilers at 92,000 area source facilities nationwide will be impacted by the final rule, 85 percent of which EPA considers to be small businesses or entities.

Long-Awaited HIPAA Rule Finally Arrives

On January 17, 2013, the Department of Health and Human Services released the long-awaited final rule modifying the Health Insurance Portability and Accountability Act (HIPAA) regulations. The final rule, at 563 pages, is sure to cause a spike in sales of printer toner.

Court Grants Summary Judgment to Hospital on Patient’s Emergency Medical Treatment and Active Labor Act (“EMTALA”) Claims

William Romine went to the emergency room at St. Joseph-Mount Sterling hospital in Mount Sterling, Kentucky, after cutting his hand with a pair of scissors while trying to unclog a bottle of Gorilla Glue. . Romine was not immediately seen at St. Joseph-Mount Sterling because no beds were available. Unsatisfied with having to wait, he left to go to another hospital in Winchester, Kentucky. During the trip to the second hospital, Romine decided to return back to St. Joseph-Mount Sterling, where he was again told there were no available beds. A short while later Romine received treatment to temporarily stop the bleeding. St. Joseph-Mount Sterling determined that it was unable to treat the injury and Romine was airlifted to another hospital where his bleeding was stopped by the placement of sutures.

OCR De-Identificiation Guidance

The Department of Health and Human Services Office for Civil Rights (“OCR”) recently released guidance on de-identification of protected health information pursuant to the Health Insurance Portability and Accountability Act (“HIPAA”) Privacy Rule. The guidance discusses in detail the two methods that satisfy the de-identification standard of the Privacy Rule—the Expert Determination and Safe Harbor methods. While these methods are not new, the guidance provides a clearer picture of OCR’s expectations.

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