Today the U.S. Department of Health and Human Services, Office for Civil Rights (“HHS”) announced a $3,000,000 settlement for a disclosure of patient protected health information (“PHI”) via its FTP server. In 2014, HHS received an email tip that the social security numbers of Touchstone Medical Imaging (“Touchstone”) patients were accessible online via an insecure file transfer protocol (“FTP”) web server.  HHS confirmed that this information was accessible via a simple Google search. Both the…
Tucker Arensberg, P.C. is pleased to announce that Michael A. Cassidy has been honored as one of only seven healthcare lawyers in the nation to be selected in 2019 as a Fellow of the American Health Lawyers Association (“AHLA”). Only a fraction of 1% of AHLA’s nearly 14,000 members are selected for fellowship annually. This honor recognizes the career long achievements, the contributions and tenure with AHLA, and their continuing service and leadership in the…
On April 4, 2019, CMS issued the final Medicare Advantage Rule for calendar year 2020, announcing it will allow Medicare Advantage carriers to significantly increase the range of telehealth services beyond traditional Medicare Part B covered services, stipulating only that, if a service is to be covered as a telehealth service, it must also be covered as an in-person service. Attached are: A link to a PDF of the CMS summary in the rule entitled…
The Patient Test Result Information Act was effective December 23, 2018. The Act requires entities performing diagnostic imaging services, defined to include any medical imaging test intended to diagnose the presence or absence of a disease, to provide notice of the results to patients.  The operative language states: “When, in the judgment of the entity performing a diagnostic imaging service, a significant abnormality may exist, the entity performing the diagnostic imaging service shall directly notify…
Although there have been a number of issues raised by the Pennsylvania Attorney General in the UPMC/Highmark situation, including UPMC’s status as a charitable institution, the primary issue in the Attorney General’s lawsuit was a request to extend the June 30, 2019 termination date for the UPMC-Highmark Consent Decrees. The Commonwealth Court declined to extend the term of the Consent Decree. Click here to read the opinion.…
Below is a summary of UPMC-Highmark dispute as of March 4, 2019. This information is limited to litigation proceedings with no discussion about prior contracts or negotiations. March 2011 – UPMC announces it will not renew UPMC-Highmark contract due to expire December 31, 2012. May 1, 2012 – Parties enter into mediated agreement which states that parties (UPMC and Highmark) will allow in-network access for all commercial, Medicare and Medicare Advantage members through December 31,…
Below is a summary of UPMC-Highmark dispute as of February 22, 2019. This information is limited to litigation proceedings with no discussion about prior contracts or negotiations. March 2011 – UPMC announces it will not renew UPMC-Highmark contract due to expire December 31, 2012. May 1, 2012 – Parties enter into mediated agreement which states that parties (UPMC and Highmark) will allow in-network access for all commercial, Medicare and Medicare Advantage members through December 31,…
As part of the 2019 Medicare annual inpatient prospective payment system (PPS) fee schedule update, CMS has added a “rule” requiring hospitals to publish a list of standard charges beginning January 2019. CMS explained this initiative under the “Transparency” and “Request for Information” topics in the following link:  https://www.cms.gov/newsroom/fact-sheets/fiscal-year-fy-2019-medicare-hospital-inpatient-prospective-payment-system-ipps-and-long-term-acute-0 CMS subsequently issued two sets of Frequently Asked Questions (FAQs) regarding this rule. Essentially, the guidance states as follows: Hospitals are free to choose whatever format…