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January 10, 2020 03:37 PM UPDATED AN HOUR AGO HARRIS MEYER A California appellate court has rejected Dignity Health’s claim that L.A. Care Health Plan, a large Medicaid plan, owes it tens of millions of dollars in out-of-network bills for inpatient care following stabilization of...
January 09, 2020 SHELBY LIVINGSTON The U.S. Justice Department recovered more than $2.6 billion in 2019 from lawsuits involving healthcare fraud and false claims, federal data released Thursday show. The department’s recoveries from healthcare fraud cases have inched higher in recent years from...
Nutile Law would like to wish all of our clients a Vibrant Holiday Season and a New Year filled with Joy, Peace and Prosperity.
December 18, 2019 SHELBY LIVINGSTON A federal appeals court ruled on Wednesday that the Affordable Care Act’s individual mandate is unconstitutional, but it stopped short of striking down the entire healthcare law. Two judges on the three-judge panel at the 5th U.S. Circuit Court of Appeals...
American Bar Association November 22, 2019 On November 15, CMS issued a Final Rule that will permit hospices to accept drug orders from a physician, a nurse practitioner (“NP”), or a physician assistant (“PA”). In 2018, CMS had issued a Final Rule amending the regulatory definition of “attending...
Photo Credit: (AP Photo/Rich Pedroncelli, File) (ASSOCIATED PRESS) November 18, 2019 03:34 PM HARRIS MEYER Sutter Health and a group of physicians agreed to pay the federal government $46.1 million to settle allegations that it violated the Stark law by billing Medicare for...
U.S. News and Best Lawyers Release 2020 “Best Law Firms” Awards WASHINGTON – Nov. 1, 2019 – U.S. News & World Report and Best Lawyers®, for the 10th consecutive year, collaboratively announce the release of the “Best Law Firms” rankings. Firms included in the...
October 23, 2019 The Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services has imposed a civil money penalty of $2,154,000 against Jackson Health System (JHS) for violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA)...
October 09, 2019 Michael Brady and Erica Teichert HHS on Wednesday unveiled its long-awaited proposal to change enforcement of anti-kickback laws, suggesting value-based payments and coordinated care should not fall under the Stark law’s purview. In two proposed rules from the CMS and...
October 05, 2019 SHELBY LIVINGSTON Dr. Paul Harari, a radiation oncologist, likened it to torture. The interminable back and forth. The outdated fax machines. Wasting time on the phone to convince a health plan’s medical director that a cancer treatment the plan denied is...
Nutile Law is pleased to announce that Alia A. Najjar, M.C., Esq. joined our practice on September 23rd. Alia focuses her practice on various aspects of healthcare law. She began her legal career in California at a national law firm where she defended physicians...
October 2, 2019 Elite Dental Associates, Dallas (“Elite”) has agreed to pay $10,000 to the Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services and to adopt a corrective action plan to settle potential violations of the Health Insurance...
Ahead of this fall’s Medicare Open Enrollment, the Centers for Medicare & Medicaid Services announced on Tuesday that, on average, Medicare Advantage premiums in 2020 are expected to decline 23 percent from 2018 while plan choices, benefits and enrollment continue to increase. HHS Secretary...
September 18, 2019 SUSANNAH LUTHI While hospitals groups have welcomed a federal judge’s ruling against the CMS’ expansion of site-neutral payments for basic doctor’s visits, some analysts see it as a short-term solution that can’t survive as a long-term strategy. U.S. District Judge Rosemary Collyer’s ruling...
September 05, 2019 Associated Press After relying on the federal HealthCare.gov website for five years, Nevada officials are preparing to switch back to a state-run insurance website where people can shop for and enroll in health coverage. The online insurance marketplaces are a hallmark...
August 26, 2019 SUSANNAH LUTHI An Oklahoma state judge on Monday ruled that Johnson & Johnson fed the state’s opioid addiction crisis with aggressive marketing and sales, ordering the company to pay $572 million. The manufacturers’ “false, misleading and dangerous marketing campaigns have caused...
August 19, 2019 11:28 AM MARIA CASTELLUCCI The CMS announced Monday that it plans to change the controversial methodology used for its hospital star ratings in early 2021. The agency didn’t disclose specific details about what the changes will entail but it will propose...
Best Lawyers Names Top Lawyers in America AUGUSTA, Ga., Aug. 15, 2019 Maria Nutile was recently selected by her peers for inclusion in the 26th Edition of The Best Lawyers in America for her work in Health Care Law. Best Lawyers®, the only purely...
August 08, 2019 05:30 PM JESSICA KIM COHEN Allscripts Healthcare Solutions on Thursday announced it had reached a tentative settlement with the Justice Department to resolve investigations of a company the electronic health records vendor acquired last year. Practice Fusion, which Allscripts acquired in...
August 02, 2019 04:50 PM SHELBY LIVINGSTON A whistleblower has alleged that DaVita Kidney Care and Fresenius and charity organization American Kidney Fund were involved in a years-long kickback scheme in which patients were incentivized to use only those dialysis providers who donated to...
July 30, 2019 04:02 PM JESSICA KIM COHEN The CMS on Monday issued several proposed rules that, among other changes, would require hospitals to publish payer-negotiated prices for various services alongside standard gross charges. The goal is to make it easier for patients to understand the...
July 30, 2019 04:16 PM MARIA CASTELLUCCI The CMS is asking stakeholders if hospitals should report quality information on their websites alongside retail charges. Tucked within its 819-page Medicare Outpatient Prospective Payment System proposed rule this week, the CMS requested feedback on ways patients can have...
July 29, 2019 05:07 PM Shelby Livingston, Alex Kacik and Susannah Luthi The CMS issued several proposed rules on Monday that it hopes will make it easier for patients to understand the cost of a hospital service before accessing care. Starting in January...
Becker’s Hospital Review Kelly Gooch President Donald Trump has signed an executive order that aims to lower healthcare costs by improving price transparency. Seven things to know: 1. The order, signed June 24 at the White House, directs HHS to develop rules requiring hospitals to publish...
June 19, 2019 05:12 PM TARA BANNOW UnitedHealth Group announced Wednesday it has closed on its $4.3 billion purchase of DaVita Medical Group after the parties reached a settlement with the Federal Trade Commission that resolves the federal government’s concerns about harm to competition in Nevada....
Companies will divest assets to preserve competition in the Las Vegas area of Nevada June 19, 2019 Healthcare provider and insurer UnitedHealth Group Incorporated and healthcare provider DaVita, Inc. have agreed to a settlement to resolve Federal Trade Commission allegations that UnitedHealth Group’s proposed $4.3 billion...
June 04, 2019 SUSANNAH LUTHI A federal judge who has refused for months to sign off on the $69 billion CVS-Aetna merger reiterated on Tuesday that he wants to look at any potential harm that the deal might cause for the public. U.S. District Judge Richard Leon...
June 03, 2019 11:08 AM SUSANNAH LUTHI The U.S. Supreme Court on Monday ruled that HHS improperly changed its Medicare disproportionate-share hospital payments when it made billions of dollars in cuts. In a 7-1 decision, the justices said HHS needed a notice-and-comment period for the Medicare DSH...
May 24, 2019 The HHS Office for Civil Rights (OCR) has issued a new fact sheet that provides a clear compilation of all provisions through which a business associate can be held directly liable for compliance with certain requirements of the HIPAA Privacy, Security,...
May 23, 2019 Medical Informatics Engineering, Inc. (MIE) has paid $100,000 to the Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services, and has agreed take corrective action to settle potential violations of the Health Insurance Portability and Accountability...
May 22, 2019 02:04 PM SHELBY LIVINGSTON A coalition of 23 states, cities and municipalities sued HHS on Tuesday to stop its final rule that expands protections for healthcare providers that refuse to perform certain medical tests and procedures because of religious or moral...
SUSANNAH LUTHI President Donald Trump and White House officials on Thursday threw their weight behind a congressional ban on surprise medical bills based on contract reforms, such as barring hospital contracts with physicians who aren’t in the same insurance networks. “We’re going to hold...
The new guidance provides greater detail about what prosecutors should look for in compliance programs. By C. Ryan Barber| April 30, 2019 at 05:19 PM The U.S. Justice Department issued new guidance Tuesday detailing how prosecutors will evaluate the effectiveness of corporate programs to prevent fraud and other...
CARE DELIVERY SHELBY LIVINGSTON The CMS finalized a rule on Friday that would give Medicare Advantage plans more flexibility to offer additional telehealth services to seniors as part of their basic benefits package starting in 2020. The rule, proposed in October 2018, allows seniors to...
April 09, 2019 02:00 PM Associated Press Federal authorities said Tuesday they’ve broken up a $1.2 billion Medicare scam that peddled unneeded orthopedic braces to hundreds of thousands of seniors via foreign call centers. The Justice Department announced charges against 24 people across the...
April 3, 2019 In 2019, OCR moved to quarterly cybersecurity newsletters. The purpose of the newsletters remains unchanged: to help HIPAA covered entities and business associates remain in compliance with the HIPAA Security Rule by identifying emerging or prevalent issues, and highlighting best...
March 27, 2019 08:28 AM UPDATED 8 HOURS AGO Modern Healthcare Centene Corp. on Wednesday said it will buy fellow Medicaid insurer WellCare Health Plans in an estimated $17.3 billion deal. All in all, the two insurers would cover nearly 22 million people in Medicare,...
SHELBY LIVINGSTON March 22, 2019 04:24 PM Lawmakers and government officials are seeking to ramp up scrutiny over electronic health records. A week after whistleblower allegations against Community Health Systems’ related to its electronic health record implementation were revealed, Rep. Jim Banks (R-Ind.) asked the National...
The Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services (HHS) announced today that it issued a Notice of Resolution to the State of Hawaii after Hawaii took corrective action in response to OCR’s investigation of complaints of discrimination...
March 14, 2019 04:51 PM UPDATED 4 HOURS AGO SHELBY LIVINGSTON A whistleblower accused Franklin, Tenn.-based Community Health Systems of submitting hundreds of millions of dollars in false claims to HHS for federal incentive payments for meaningfully using electronic health records. The lawsuit, unsealed by...
Modern Healthcare, March 06, 2019 05:23 PM Amazon, Berkshire Hathaway and JPMorgan Chase’s year-old and highly touted joint venture will be called Haven. The venture’s newly launched website reveals few details about the widely anticipated, not-for-profit entity. The three parent companies said in January that they would...
The Office for Civil Rights (OCR) at the U.S Department of Health and Human Services concluded an all-time record year in Health Insurance Portability and Accountability Act (HIPAA) enforcement activity. In 2018, OCR settled 10 cases and was granted summary judgment in a case...
By Susannah Luthi | January 29, 2019 The Senate Finance Committee on Tuesday signaled interest in bolstering key points in the Trump administration’s drug-pricing blueprint, including potential structural reforms for Medicare Part B and Part D. Senators from both sides of the aisle waded into a proposal...
By Robert King | January 31, 2019 HHS issued a long-awaited proposed rule on Thursday that excludes the rebates drugmakers pay to pharmacy benefit managers on Medicare Part D plans from protections from anti-kickback laws. The proposed rule also applies to safe harbor protections for...
By Colton Lochhead / Las Vegas Review-Journal January 30, 2019 – 7:32 pm CARSON CITY — The Nevada Attorney General’s office got the OK Wednesday to hire a law firm to sue opioid manufacturers. The Interim Finance Committee approved the request for the Attorney General’s...
By Susannah Luthi | January 18, 2019 The CMS Innovation Center on Friday announced a new model to try to shrink skyrocketing Medicare Part D drug spending, and expanded its so-called value-based insurance design model for Medicare Advantage plans across all 50 states. The strategy...
By Susannah Luthi | January 14, 2019 The Supreme Court on Tuesday will hear arguments in an appeal over whether HHS can recalculate its Medicare disproportionate-share hospital payments without going through the full rulemaking process to get public input on the change. HHS petitioned the high court to take the...
By Harris Meyer | December 20, 2018 A physician independent practice association in Tennessee has won a $58 million class-action judgment against Wellmont Health System based on allegations that the system tried to undermine the IPA and signed payer contracts outside the physician network. Highlands Physicians, a...
By Jessie Bekker / Las Vegas Review-JournalDecember 20, 2018 – 6:20 pm UnitedHealth Group’s Optum is dropping plans to purchase the DaVita Medical Group physician clinics in Nevada after the Federal Trade Commission investigated the deal’s compliance with antitrust regulations. DaVita, in a U.S. Securities...
May the Spirit of the Season Bring You Peace, Health and Happiness with a Year Full of Abundance and Joy.
Pagosa Springs Medical Center (PSMC) has agreed to pay $111,400 to the Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services and to adopt a substantial corrective action plan to settle potential violations of the Health Insurance Portability and...
December 4, 2018 Advanced Care Hospitalists PL (ACH) has agreed to pay $500,000 to the Office for Civil Rights (OCR) of the U.S. Department of Health and Human Services (HHS) and to adopt a substantial corrective action plan to settle potential violations of...
Allergy Associates of Hartford, P.C. (Allergy Associates), has agreed to pay $125,000 to the Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services (HHS) and to adopt a corrective action plan to settle potential violations of the Health Insurance...
Nutile Law wishes all of our clients and friends a happy, healthy Thanksgiving filled with laughter and joy!
By Virgil Dickson | November 8, 2018 The CMS plans to unveil a mandatory Medicare payment model for cancer patients, and two new voluntary models for cardiac care in the coming weeks, said HHS Secretary Alex Azar. That means the Trump administration is reversing course...
Washington, D.C. – U.S. News & World Report and Best Lawyers®, for the ninth consecutive year, collaboratively announce the release of the “Best Law Firms” rankings. 2019 marks the third consecutive year that Nutile Law has been included in the “Best Law Firms” rankings, for Health Care...
October 15, 2018 Anthem, Inc. has agreed to pay $16 million to the U.S. Department of Health and Human Services, Office for Civil Rights (OCR) and take substantial corrective action to settle potential violations of the Health Insurance Portability and Accountability Act (HIPAA)...
By Jeff Overley Law360 (October 15, 2018, 4:33 PM EDT) The Trump administration on Monday unveiled its proposal to require disclosure of drug prices in pharmaceutical advertisements, a controversial move likely to draw a legal challenge from the pharmaceutical industry. The U.S. Department of...
By Matthew Perlman Law360 (October 10, 2018, 11:07 AM EDT) — The U.S. Department of Justice said Wednesday that it has cleared CVS Health Corp.’s planned $69 billion deal for health insurer Aetna Inc. after the companies agreed to sell off a Medicare prescription drug plan business to WellCare....
By Virgil Dickson | October 6, 2018 Gina Intinarelli is a true believer in the impact of value-based payment models. She has seen them improve the quality of care for patients while reducing spending. However, just days after the launch of a new federal bundled-payment effort, she...
By Virgil Dickson | Modern Healthcare | October 4, 2018 The CMS has prided itself in recent months on cutting and scaling back providers’ regulatory burden, but those efforts have fallen short, according to a new survey by the Medical Group Management Association. An overwhelming majority, or...
September 20, 2018 Today, the Department of Health and Human Services, Office for Civil Rights (OCR) announced that it has reached separate settlements with Boston Medical Center (BMC), Brigham and Women’s Hospital (BWH), and Massachusetts General Hospital (MGH) for compromising the privacy of patients’...
The U.S. Department of Health and Human Services awarded over $1 billion in opioid-specific grants this week to help combat the crisis ravaging our country. New data unveiled recently by HHS suggests that efforts are now yielding progress at the national level. Read the...
The U.S. Justice Department has approved the proposed $67 billion merger between health insurer Cigna Corp. and pharmacy benefit manager Express Scripts, the companies announced Monday. Read the full article here.
Maria Nutile was named the Best Lawyers® 2019 Health Care Law “Lawyer of the Year” in Las Vegas. This marks the third time in the past five years that Maria has been honored by her peers with this esteemed recognition. “Lawyer of the Year” honorees...
July 2018 OCR Cybersecurity Newsletter: Because the technology and computer equipment that organizations use may contain components that store sensitive information, organizations should consider whether their process for disposing of electronic devices and media does so in a secure manner. Examples of such...
The shift toward value-based payment in healthcare that countless advocates say will cut costs and improve the quality of care isn’t without its downsides. This week’s earnings show the evolution is weighing on some providers’ bottom lines. Read full article here
Bridget Kelly, associate at Nutile Law, gave a presentation covering licensure, discipline, and employment contract negotiation to Dr. Weldon Havin’s Physician Assistant students at Touro University Wednesday morning, July 11th. Ms. Kelly focuses her practice on Health Care Law, providing comprehensive legal services in...
The Trump administration is halting billions of dollars of payments to insurers under the Affordable Care Act’s risk-adjustment program, a move that further disrupts the insurance market and could lead to more premium increases next year. Read the full article here.
The Department of Health and Human Services Office of Inspector General, along with our state and federal law enforcement partners, participated in the largest health care fraud takedown in history in June 2018. More than 600 defendants in 58 federal districts were charged with...
June 18, 2018 A U.S. Department of Health and Human Services Administrative Law Judge (ALJ) has ruled that The University of Texas MD Anderson Cancer Center (MD Anderson) violated the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy and Security Rules and...
A federal appeals court on Thursday ruled that the U.S. government does not owe health insurers billions of dollars in unpaid risk-corridor funds meant to offset losses during the early years of the Affordable Care Act exchanges. Read full article here.
Oncologists sued HHS Thursday over the continued 2% cuts to Medicare Part B drug reimbursements packed in the budget sequester, claiming Congress never gave HHS authority to change the reimbursement formula. Read full article here.
We are pleased to announce the addition of Ethan Minkin to our legal team. Ethan is a seasoned attorney with substantial experience as both a private practice attorney and an in-house attorney, and has counseled clients on a wide variety of matters. His expertise includes...
Can the FDA compel drug makers to disclose prices in TV commercials? The Trump administration sees this as a key strategy for reining in the cost of medications, but it raises many legal questions and concerns that listing prices without context would be misleading...
Medicare will be requiring hospitals to post prices online. They are already required to disclose prices publicly, but this change would require them to put this information online. This reflects the on-going efforts by the Trump administration to encourage patients to become better decision...
Are there likely to be major 2018 HIPAA changes? What does this year have in store in terms of new HIPAA regulations? OCR Director Roger Severino has hinted there could be some 2018 HIPAA changes and that HIPAA enforcement in 2018 is unlikely to...
Running a business is increasingly complex. The decisions made on behalf of your business today will have far-reaching implications in the future. With spring in the air, it may be time for a business health assessment or checkup. Detecting potential concerns provides time to...
Healthcare leaders worry Supreme Court case on union fees could hurt workplace harmony and quality of care By Harris Meyer | February 23, 2018 Joyce Robertson has been a public health nurse with the Cook County Health & Hospitals System in Chicago for 24 years. She says...
February 13, 2018 Consequences for HIPAA violations don’t stop when a business closes A receiver appointed to liquidate the assets of Filefax, Inc. has agreed to pay $ 100,000 out of the receivership estate to the U.S. Department of Health and Human...
Senate leaders announced a two-year, $400 billion spending deal on Wednesday afternoon that will free up appropriations to battle the opioid epidemic and extend funding for CHIP for another four years. Read Full Article here.
Nutile Law would like to wish all of our clients a Vibrant Holiday Season and a New Year filled with Joy, Peace and Prosperity.
Controlled substances for the treatment of pain can be highly effective and medically necessary HOWEVER, the current opioid epidemic and overdose rates associated with prescription drug abuse, misuse and diversion underscores that such medications are not without inherent risks. Full article here.
WASHINGTON – Nov. 1, 2017 – U.S. News & World Report and Best Lawyers, for the eighth consecutive year, announce the “Best Law Firms” rankings. Nutile Law is pleased to announce they have been recognized again this year in the “Best Law Firms” rankings. Firms...
Following President Trump’s call to action yesterday that led to the declaration of a nationwide public health emergency regarding the opioid crisis, the HHS Office for Civil Rights is releasing new guidance on when and how healthcare providers can share a patient’s health information...
On October 6, 2017, the Trump Administration announced “Interim Final Rules” which expand exemptions to the contraceptive mandate of the Patient Protection and Affordable Care Act of 2010 and the Health Care and Education Reconciliation Act of 2010 (collectively, the “ACA,” commonly referred to...
Nutile Law mourns the tragedy that has shocked our Las Vegas home. We grieve for those who endured the trauma and loss of the unthinkable. The heroism displayed by our first responders, residents, and visitors has inspired hope and renewed faith in this dark...
As Hurricane Irma approaches, hospitals, medical professionals and emergency medical personnel in the path of the storm are actively preparing for the storm’s arrival. Making sure that health information is available before, during and after the storm is a critical part of that preparation. U.S....
Maria Nutile was recently selected by her peers for inclusion in The Best Lawyers in America©. The 24th edition of The Best Lawyers in America includes attorneys in 145 practice areas, covering all 50 states and the District of Columbia. Best Lawyers selections are...
Effective June 3, 2017, AB 276 amends NRS Chap 613, requiring courts to revise, rather than wholly reject, unreasonable employment contract non-compete provisions: “If an employer brings an action to enforce a noncompetition covenant and the court finds the covenant is supported by valuable...
A recent report by the Department of Health and Human Services Office of the Investigator General (OIG) (“Medicare Paid Hundreds of Millions in Electronic Health Record Incentive Payments That Did Not Comply With Federal Requirements,” (A-05-14-00047), June 2017) claims that an estimated $729,424,395 in...
Nutile Law has been making a positive impact in the local business and health care community since 2002. June 2017 marks the 15th anniversary for the firm, which has had a very busy year. The firm relocated their office to the Pecos Springs Business Park,...
Popular electronic health records (EHR) software company eClinicalWorks (ECW), along with three of its founding officers and several employees, have agreed to pay $155 million to settle False Claims Act (FCA) allegations, according to a Department of Justice (DOJ) announcement on May 31, 2017....
From: OCR HIPAA Privacy Rule information The Center for Children’s Digestive Health (CCDH) has paid the U.S. Department of Health and Human Services (HHS) $31,000 to settle potential violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule and agreed...
We are pleased to welcome Bridget Kelly as a new associate. Ms. Kelly has worked as a law clerk for the firm for two years. Having earned the respect of clients and peers alike, Ms. Kelly will focus her practice on Health Care Law,...
Health care is among the most highly regulated industries in the United States which makes compliance and conducting on-going risk analysis crucial. Failure to implement a proper security management process can be costly. From: OCR HIPAA Privacy Rule information The U.S. Department of...
Protecting health information and responding to filings in a timely manner is essential to the Health of Your Business; a lack of risk management costs individuals the security of their data, and can also cost covered entities a sizable fine, to the tune of...