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Appellate Ruling Revives Lawsuit Over Horizon BCBS Breach Print E-mail
Written by FHI's Week in Review   
Monday, 30 January 2017 20:12

Evan Sweeney reports in a Jan. 24, 2017 Fierce Healthcare post:

An appellate court ruling has breathed new life into a class-action lawsuit against Horizon Blue Cross Blue Shield over a healthcare data breach in 2013 that exposed more than 800,000 patient records.

The United States Court of Appeals for the Third Circuit vacated a district court's 2015 dismissal and remanded the case, arguing that although the four plaintiffs had not presented evidence that their information was used improperly, the fact that their personal information was stolen was enough to warrant a potential injury under federal law.

Read more in the current issue of Week in Review>>

Last Updated on Tuesday, 21 February 2017 19:03
New exclusion rules to take effect next month Print E-mail
Written by Vitale Health Law   
Monday, 30 January 2017 00:00

Earlier this month, the Health and Human Services Office of the Inspector General (HHS-OIG) finalized its long-awaited rules on civil monetary penalties that could make it easier for providers to be excluded from participating in the Medicare and Medicaid programs.

The final rule, which was published in the Federal Register on January 12, was first proposed in 2014 and updates HHS' exclusion authority to include those who are found guilty of obstructing audits. Previously, only those convicted of obstructing criminal investigations faced program exclusion.

The final rule, which takes effect Feb. 13, builds on changes implemented by the Affordable Care Act to expand OIG's authority even more.

The new rule did, however, implement a 10-year statute of limitations, which the OIG noted "addresses the commenters' concerns about administrative burden and courts' historical favoring of an enumerated limitations period."

On average, OIG noted that it excludes approximately 3,500 healthcare providers per year.

The length of exclusion is determined by a number of factors including: previous convictions for healthcare fraud, the amount of the financial loss, and the reason for the exclusion.

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Florida Institute of CPAs Annual Health Care Industry Conference Print E-mail
Written by FICPA   
Friday, 27 January 2017 00:00

Health care is a profession under constant change, especially under a new administration. New rules and regulations are introduced with regularity.  What can you do to keep pace with this ever-evolving industry? Want to learn the best strategies for guiding your organization and clients? The 2017 FICPA Health Care Conference is for you!

This specialized, 17-hour conference covers implementation of the new standard for not-for-profits, post election concerns, revenue recognition and much more. There is a dedicated A & A track, and a specialized "new to health care/young CPA" track designed to get you up to speed on the things you need to know.

Date: Thursday, April 20, 2017 - Friday, April 21, 2017

Time: 8:00 am - 5:50 pm (opens at 7:30am)

Location: Caribe Royale Resort Suites, Orlando

Learn More>>

Last Updated on Friday, 03 February 2017 18:00
AMA: Court Order in Aetna-Humana Merger Halts a Bad Deal for Elderly Patients Print E-mail
Written by Andrew W. Gurman, MD, President | American Medical Association   
Monday, 23 January 2017 00:00

Elderly patients were the big winners today <1.23.17> as a federal court imposed an injunction on Aetna's $37 billion acquisition of Humana. The court ruling halts Aetna's bid to become the nation's largest seller of Medicare Advantage plans and preserves the benefits of health insurer competition for a vulnerable population of seniors.

Aetna's strategy to eliminate head-to-head competition with rival Humana posed a clear and present threat to the quality, accessibility and affordability of health care for millions of seniors. The AMA applauds the extraordinarily well documented, comprehensive, fact-based ruling of U.S. District Judge John D. Bates, which acknowledged that meaningful action was needed to preserve competition and protect high-quality medical care from unprecedented market power that Aetna would acquire from the merger deal. Importantly, Judge Bates further concluded that the merger would unlawfully restrain competition in the sale of individual commercial insurance on the public exchanges in three counties in Florida identified in the complaint.

The court's ruling sets a notable legal precedent by recognizing Medicare Advantage as a separate and distinct market that does not compete with traditional Medicare. This was a view advocated by the AMA, as well as leading economists. AMA also applauds the decision for protecting competition on the public exchanges.

The AMA's stand against this anti-competitive merger shows again that when doctors join together, the best outcome for patients and doctors can be achieved. Given the troubling consolidation trends in health insurance industry, the AMA will continue to advocate on behalf of patients and physicians to foster more competitive health insurance markets.

Last Updated on Tuesday, 24 January 2017 19:43
Drugmakers Manipulate Orphan Drug Rules To Create Prized Monopolies Print E-mail
Written by Sarah Jane Tribble and Sydney Lupkin | KHN   
Tuesday, 17 January 2017 19:03

khn logo black More than 30 years ago, Congress overwhelmingly passed a landmark health bill aimed at motivating pharmaceutical companies to develop new drugs for people whose rare diseases had been ignored.

By the drugmakers' calculations, the markets for such diseases weren't big enough to bother with.

But lucrative financial incentives created by the Orphan Drug Act signed into law by President Ronald Reagan in 1983 succeeded far beyond anyone's expectations. More than 200 companies have brought almost 450 "orphan drugs" to market since the law took effect.

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Last Updated on Monday, 06 February 2017 19:22
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