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The Legal Stuff
BT Health Law Blog
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23 May 2016 State Regulation of Telepharmacy

This article was previously published on Pharmacy Times.   State regulation of telepharmacy varies depending on the market-driven needs within each particular state. The first state to regulate telepharmacy was North Dakota. In 2001, the state’s Board of Pharmacy promulgated rules for a telepharmacy pilot program in an effort to combat the closure of pharmacies in rural areas. Under the program, pharmacies could operate remote sites without the physical presence of a pharmacist, so long as the pharmacy maintained a central site staffed by a…

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20 May 2016 Telehealth Expansion Initiatives Helping to Increase Patient Choice and Access

The United States boasts the largest market for the use of telehealth and telemedicine services, generating $14 billion in global business last year with a predicted increase of nearly $20 billion by as early as 2020. Despite its size, the U.S. telehealth industry faces issues with broadband connectivity, regulatory hurdles like provider licensing restrictions and limitations on prescription orders and concerns over its potential to cause even more overutilization of healthcare services.   At the simplest level, “telemedicine” or “telehealth” is all healthcare practiced at…

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22 Apr 2016 CMS to Reverse Payment Cuts Made Under “Two-Midnight” Rule

On April 18, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that addresses the controversial inpatient payment cuts resulting from the so-called “two-midnight” rule.  The two-midnight rule, which was introduced in the Fiscal Year (FY) 2014 Inpatient Prospective Payment System (IPPS) final rule, said that inpatient payment under Medicare Part A was generally only appropriate if the patient’s hospital stay was expected to span two midnights. If the patient’s stay was expected to be less than two midnights, the care should generally…

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04 Apr 2016 New Indiana Law Expands Use of Telemedicine

Indiana Gov. Mike Pence recently signed into law House Enrolled Act (HEA) 1263, which expands physicians’ use of telemedicine. HEA 1263 will permit providers, which include physicians, optometrists, and advance practice nurses and physician assistants with prescriptive authority, to prescribe certain prescriptions, drugs and devices during remote patient visits. Currently, Indiana allows the prescribing of drugs through telemedicine only if a provider first examines a patient in person.   Effective July 1, HEA 1263 will provide greater convenience to patients located in rural areas by eliminating…

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01 Apr 2016 DOJ Launches Targeted Elder Justice Task Forces

On March 30, the Department of Justice (“DOJ”) announced the formal launch of 10 regional Elder Justice Task Forces designed to identify nursing homes and other long-term care (“LTC”) facilities that provide “grossly substandard care” to residents.   Similar to DOJ’s previously launched Medicare Fraud Strike Force and Health Care Fraud Prevention & Enforcement Action Team (“HEAT”) initiative, the newly created Elder Justice Task Forces will focus on coordination and information sharing among federal, state and local enforcement agencies to combat suspected cases of physical…

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21 Mar 2016 OCR Releases Details of Phase 2 HIPAA Audit Program

  The Office for Civil Rights (OCR) announced Phase 2 of its HIPAA audits, according to a public announcement. In its 2016 Phase 2 Audit Program, OCR will review the policies and procedures of selected covered entities and business associates to examine compliance with the HIPAA Privacy, Security and Breach Notification Rules.   Every covered entity and business associate is eligible for an audit, which will consist of three phases. The first set of audits will be desk audits for covered entities while the second…

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17 Feb 2016 CMS Relaxes 60-day Overpayment “Look Back” Period for Medicare Providers

  Federal regulators have relaxed the provider reporting obligations for overpayments by decreasing the period of time providers or suppliers must “look back” when reporting and repaying overpayments from ten to six years. The final rule issued by the Centers for Medicare and Medicaid Services (CMS) on Feb. 11, provides much needed clarity and consistency for providers and suppliers who participate in the Medicare program.   Section 1128J(d)(1) of the Social Security Act requires a provider who has received an overpayment to report and return the overpayment to…

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15 Feb 2016 Physician Owed Duty to Nurse Practitioner’s Patient

  The Indiana Court of Appeals recently held that a physician, who entered into a collaborating practice agreement (CPA) with a nurse practitioner, had a duty of care to the nurse practitioner’s patient even though the physician never treated or saw the patient.   In John Collip, M.D. v. Vickie Ratts on behalf of Robert A.J. Ratts, deceased, and Little Creek Family Health Center, LLP, Dena Barger, a nurse practitioner who owns her own practice, saw her patients under a CPA with Dr. John Collip….

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15 Jan 2016 Hospitals Mount Another Challenge to the CMS “2 Midnights” Policy and Reductions in Reimbursement Rates

  On Jan. 8, 55 general acute care hospitals from 19 different states filed suit against U.S. Department of Health and Human Services (HHS) Secretary Sylvia Matthews Burwell.   The suit alleges that the Centers for Medicare & Medicaid Services’ (CMS) decision to institute a 0.2 percent decrease in hospital payment rates from FY 2014 through FY 2018 violated the Administrative Procedure Act (APA) because the rule was finalized without following proper notice and comment procedures. The plaintiffs’ further allege that the rule was arbitrary,…

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14 Jan 2016 Illinois Appellate Court Rules Hospital Tax Exemption Law Unconstitutional

  Last week, in a unanimous ruling, the Illinois Appellate Court for the Fourth District declared that a state law granting property tax exemptions to hospitals was unconstitutional. The Fourth District’s ruling could have ramifications for a number of Illinois hospitals, but it remains to be seen whether the decision will be reviewed by the Illinois Supreme Court.   The case originated when a hospital system, after being assessed a tax bill by its local jurisdiction, sought a declaratory judgment from the circuit court that…

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