On December 22, 2011, an equally divided Pennsylvania Supreme Court dramatically extended liability for negligent infliction of emotional distress (“NIED”) to “special relationship” breach of contract or breach of fiduciary duty cases, in Toney v. Chester County Hospital, —A.3d— (Pa. 2011), 2011 WL 6413948. The decision exposes health care providers to liability where there is a… Read more »
Center for Medicare Services (CMS) Issues Final Rules on Accountable Care Organizations (ACO) CMS recently issued final rules on ACOs (under the Medicare Shared Savings Program) that encourage a variety of health care providers to form networks to deliver more efficient care. Initially, CMS proposed that ACO’s share not only in the cost savings generated, but… Read more »
According to a recent special edition article in the Center for Medicare & Medicaid Services’ (CMS) online MLN Matters, a publication for Medicare professionals, physicians who enrolled in Medicare before March 25, 2011 and provide health care for Medicare patients will be required to revalidate their Medicare enrollment upon receiving notification from their individual administrative contractors…. Read more »
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Eleventh Circuit Sees Constitutional Problems with Mandated Health Insurance On June 8, a panel of three federal judges heard an oral argument in Atlanta on a constitutional challenge to the Obama administration’s mandated health insurance program. The challenge was brought by 26 state Attorneys General. The central issue involves the law’s mandate that nearly everyone… Read more »
Physician and Hospital Relationships After Passage of the Patient Protection and Affordable Care Act: Collaboration To Replace Competition A major consideration in the drafting and passage of PPACA was an attempt to shift the historic competitive nature of hospital-physician relations (where hospital and physicians compete for control over diagnostic and treatment services), to a more… Read more »
HHS Fines Insurer $4.3 Million for Failing to Provide Patients Their Records and For Failing to Cooperate with Investigation Cignet Health denied forty-one (41) patients access to their medical records. The U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) investigated the patients’ complaints and made demands to Cignet to produce the… Read more »
After stepping up enforcement of fraud and abuse cases related to health care providers under the Patient Protection and Affordable Care Act, the Federal government is now targeting health care corporate structures and executives. In seeking to expand the authority provided to the HHS Office of the Inspector General (OIG), on September 22, 2010, the… Read more »
On September 15, 2010, Antonio Ochoa was convicted by a federal jury in the U.S. District Court of the Southern District of Florida of one count of conspiracy to commit health care fraud and three counts of soliciting and receiving kickbacks and bribes. Mr. Ochoa was a home health patient recruiter for home health agencies, including… Read more »
Tyler J. Smith authored the article “Five-Star Makes Complaints Against Nursing Homes Even More Serious,” which appeared in the July 6, 2010 issue of McKnight’s Long-Term Care News and Assisted Living publication. Related Information: Five-Star Makes Complaints Against Nursing Homes Even More Serious