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Navigating Legal Issues in Telemedicine

Partner Dan Frier recently joined Joe Lavelle of intrepidNOW's Healthcare podcast to discuss how to navigate the legal issues in telemedicine that are confronted by healthcare providers. Discussed are: (2:21) For those that are listening, that may not be familiar, would you provide us with a brief history lesson on telemedicine? (5:19) What are the professional liability issues with telemedicine? (6:49) Will you tell us about the current state of...

New Players in the Chronic Care Management Market and the Potential for Abuse

The introduction of reimbursement for Chronic Care Management (CCM) services by the Centers for Medicare and Medicaid Services presents an opportunity to better care for patients with chronic illnesses and to receive payment for the time spent caring for these patients. It also presents an opportunity for companies to assist physician practices in performing CCM services. You may have read recent articles about such a company, a publicly traded pharmaceutical...

OptumRx’s Acquisition of AxcelaCare Marks the First Strategic PBM Entrance into the Home Infusion Services Market

On November 17, 2015, OptumRx, a major Pharmacy Benefit Manager (PBM) owned by UnitedHealth Group, announced its purchase of a home infusion services provider, giving the PBM a window into the home infusion market. OptumRx will now provide its aging subscriber population with access to new and additional medications and enhance its ability to deliver care to patients requiring at-home infusions. This is a clear compliment to OptumRx's existing and...

Nursing Home Management Company Settles Claim that it Received Kickbacks from Ambulance Providers

In what is believed to be the first settlement of its kind, a Texas nursing home management company agreed earlier this week to pay nearly $3.2 million to settle allegations that it received kickbacks from various ambulance companies. Regent Management Services of Galveston manages 12 nursing homes, including 11 in Texas. According to Federal prosecutors, Regent was accused of accepting free or heavily discounted services for unreimbursable ambulance transportation, in...

HIPAA Compliance Violations Result in Significant Fines for Healthcare Providers

Two recent settlements by the U.S. Department of Health and Human Services Office for Civil Rights (OCR) related to potential violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) have resulted in significant fines for several providers. These settlements demonstrate the fervor with which the Federal Government is pursuing HIPAA violations. In one case a Massachusetts teaching hospital agreed to pay an $850,000 settlement related to the...