Modifier 25 On The Government’s Radar… Again
Federal Government scrutiny over healthcare providers’ use of CPT Code Modifier 25 is not new, but we are seeing an uptick in enforcement. The U.S. Department of Health and Human Services, Office of Inspector General (“OIG”), has targeted the use of Modifier 25 in its yearly work plans. The OIG’s yearly work plans outline the [...]
Clinical Lab Licensure Update
On March 20, 2018, Governor Rick Scott signed Senate Bill 622 into law, which made significant changes relevant to clinical laboratories governed by the Agency for Health Care Administration (“AHCA”). This law became effective July 1, 2018. Previously, facilities performing any “non-waived” clinical laboratory testing (i.e., testing using a microscope) had to obtain a state [...]
Direct Primary Care
On March 24, 2018, Governor Rick Scott signed House Bill 37 into law specifying that direct primary care agreements are not insurance. Under direct primary care agreements, primary care providers enter into private contracts with their patients and charge them monthly fees in advance of providing services, with no third-party billing. This law is effective [...]
Health Care Clinic Certificate of Exemption
On March 20, 2018, Governor Rick Scott signed Senate Bill 622 into law, which made significant changes relevant to various health care facilities governed by the Agency for Health Care Administration (“AHCA”). This law is effective July 1, 2018. One change is with regards to the health care clinic certificate of exemption. A health care [...]
30,000 Foot View: Asset Sale vs. Stock Sale
You have been running your business for years, perhaps even decades, and the time has come for you to transition the business to someone else. The buyer of your business could take a variety of forms, such as a key employee, family member, a competitor in your particular industry or a private equity group. Regardless [...]
New HHS Guidance Suggests EMR Vendors and Other Business Associates Cannot Hold Protected Health Information Hostage
The Department of Health and Human Services ("HHS") recently issued guidance regarding the practice of a Business Associate cutting off a Covered Entity's access to Protected Health Information ("PHI"). This may occur when a healthcare provider refuses to pay its electronic medical records (“EMR”) vendor or when the provider decides to switch vendors. The EMR vendor may [...]