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Is Your Surgery Center Ready for California’s Surprise Medical Billing Law?

A new California law (AB 72) limits the amount that out-of-network surgeons and other health care professionals may bill patients for covered non-emergency services provided at a contracted facility, such as an ambulatory surgery center.  California’s “surprise medical bill” law went into effect on July 1, 2017.  It is intended to prevent a consumer from … Continue Reading

Medical Board of California Circulates Opioid Prescriber Guidance

Recently, the Medical Board of California circulated an open letter, known as a Prescriber Guidance Letter to all practitioners in California who prescribe opiates.  The letter was authored by a statewide workgroup on Prescription Opioid Misuse and Overdose Prevention.  The workgroup includes the Medical Board of California, the Board of Pharmacy, the California Department of … Continue Reading

Press Release Mistake Leads to $2.4 Million HIPAA Penalty for Health System

On May 10, 2017, the U.S. Health and Human Services Department Office for Civil Rights (“OCR”) announced an agreement whereby Memorial Hermann Health System (“MHHS”) will pay a $2.4 million penalty for releasing a patient’s name in a press release.  According to the resolution agreement, in September 2015, a patient at an MHHS clinic presented … Continue Reading

Stable or Fable: Will the Trump Administration Proposed Rule Save the Exchanges or Hasten Their Demise?

A proposed rule intended to stabilize the individual and small group insurance markets was issued on February 17, 2017, only a week after the Senate confirmed Tom Price as the Secretary of the U.S. Health and Human Services Department (HHS).[1] Although the proposed rule is intended to stabilize these markets, it may make it more difficult for … Continue Reading

What’s in Your Local Transportation Policy?

The Anti-Kickback Statute Those in the business of providing healthcare services to Medicare and Medicaid beneficiaries are all too familiar with the federal Anti-kickback Statute (AKS). Among other dreadful sanctions, it imposes criminal penalties on those individuals or entities that knowingly and willfully offer, pay, solicit, or receive remuneration in order to induce or reward … Continue Reading

MBC Disciplinary Guidelines Relieve Licensees of Onerous Probation Condition

(Updated March 11, 2017) On February 3, 2017, the Medical Board of California (MBC) published the much-anticipated 12th Edition of its Manual of Model Disciplinary Orders and Disciplinary Guidelines (Guidelines).  Drafts of this latest edition had been slugging through the approval process since mid-2015. The most notable modification is to Standard Condition #33 (Non-practice While … Continue Reading

Opthalmologists’ Group Boycott has the FTC Seeing Red

On January 19, 2017, the Federal Trade Commission announced a settlement which would resolve allegations that competing ophthalmologists violated federal antitrust laws when they refused to negotiate contracts with MCS Advantage, Inc. (MCS), a Medicare Advantage Plan, and Eye Management of Puerto Rico (Eye Management), MCS’s network administrator. According to the complaint, the charges arise … Continue Reading
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