On Sept. 23, 2013, the Office for Civil Rights of the Department of Health and Human Services (OCR) will begin enforcing important new regulations enacted under the Health Information Technology for Economic and Clinical Health (HITECH) Act, which amends the Health Insurance Portability and Accountability Act (HIPAA). A final rule implementing the HITECH Act was published in the Federal Register on Jan. 25, 2013, but will not be enforced by OCR until Sept. 23, 2013 (the Compliance Date).
The Office of Inspector General (OIG) of the Department of Health and Human Services (DHHS) has issued an advisory opinion addressing the important issue of what constitutes a reasonable allocation of payment when a BLS transport provider jointly responds with an ALS non-transport agency and submits a “bundled bill” to Medicare. Such arrangements have become […]
A landmine for providers One of the provisions in the Patient Protection and Affordable Care Act (PPACA) that has had the greatestpractical effect on ambulance providers is the so-called “60-Day Rule,” which requires all healthcare providers who receive reimbursement from Medicare and other government programs to report and return any “overpayment” within: (a) 60 days after […]
Substantial increases in the enforcement of the Health Insurance Portability and Accountability Act (HIPAA) have been made, largely as a result of the enactment of the Health Information Technology for Economic and Clinical Health Act (the HITECH Act). These include increased penalties for violations; requirements by the U.S. Department of Health and Human Services (HHS) […]
The Office of Inspector General (OIG) of the Department of Health and Human Services (DHHS) has issued an advisory opinion addressing the important issue of what constitutes a reasonable allocation of payment when a BLS transport provider jointly responds with an ALS non-transport agency and submits a “bundled bill” to Medicare.
Federal opinion favorable to repetitive transport providers On July 11, 2011, a federal trial court in Tennessee issued a significant decision favorable to ambulance providers who perform scheduled repetitive transports for dialysis and other types of chronically ill patients. The decision, in the case of MooreCare Ambulance Service, LLC vs. Department of Health and Human […]
Decision addresses bundled payment schemes On Dec, 28, the Office of Inspector General (OIG) of the Department of Health & Human Services issued an important advisory opinion addressing the difficult topic of discounted rates provided to nursing homes (and, by implication, hospitals) for transports for which the facility has financial responsibility. The opinion, No. 10–26, […]
Many public and private ambulance providers are eligible to participate in a $350 million class action settlement agreed upon in a nationwide lawsuit brought by the American Medical Association and other plaintiffs against UnitedHealthcare Corporation and its affiliated health plans (“United”). The lawsuit, filed in 2000, alleged that United knowingly utilized a flawed database, operated […]
As of Sept. 23, 2009, new regulations require ambulance providers and other entities covered by HIPAA to notify affected individuals and the government in the event of a breach or suspected breach of “unsecured” protected health information. Fortunately, the Department of Health and Human Services, which issued and will enforce the regulations, will not penalize […]
R. Michael Scarano Jr. is a partner in Foley & Lardner, a national law firm with approximately 1,000 attorneys who practice in 18 offices throughout the U.S. He represents both public- and private-sector ambulance services in reimbursement, compliance and more.
More Articles from R. Michael Scarano, Jr.
App Store Links
EMS Insider Newsletter
Inside Current Issue
Implementing a Health Information Exchange
Documentation Differences
SARS-Like Virus a Global Threat
Recall Alert
