Credentialing is serious business. Hospitals must constantly enforce their policies, assess risk and review standard of care to stave off liability and ensure quality of care. When a hospital determines that conduct of a staff physician rises to a risky level, it refers that member to peer-review for further investigation and corrective actions.

Until Supreme Court pushed it into the forefront in the BILSKI decision, 35 USC 101 used to loom in the background of patent prosecution.  Since BILSKI, the notion of abstract ideas and natural phenomena–to be aligned with “ideas” (e.g., mathematic formula or natural relationships) has quickly crept into biotechnology patent prosecution and seriously crippled efforts to secure patent protection for biomedical discoveries, especially in the diagnostic area.

Mobile devices, including cell phones, tablets, and laptops increase the risk associated with breach of electronic Protected Health Information (ePHI). Entities regulated by HIPAA Privacy, Security and Breach Notification Rules should consider including mobile devices in their HIPAA risk analysis and take steps to reduce risks identified with the use of mobile devices.

Understanding ERISA is important to employers for three main reasons: First, ERISA governs the operations of group health benefit plans (also, 401(k) plans, retirement plans, and life and disability insurance plans). Second, ERISA gives participants and beneficiaries of group health benefit plans the right to sue for breach of fiduciary duty. Finally, employers or their employees may be held liable for breaching the provisions of the Act.

Cyber security is the new frontline of a data breach. Increased use of internet, cloud storages and technology in the medical field makes the industry susceptible to data breach. A study released by the U.S. State and Federal Government Cybersecurity in 2017, has identified the healthcare industry among the most vulnerable to cyber-attack, ranking it below food industries and retail.

Between 2011-2015, Office of Inspector General investigations have resulted in more than 350 criminal and civil actions and $975 million in receivables. The OIG and Government Accountability Office have raised concern about questionable billing patterns, compliance problems, and improper payments in home health. In the course of their investigations, OIG has identified over $10 billion in improper payments in FY 2015.

HIPAA Breach Notification Rule (45 CFR Secs. 164.400-414) requires timely notification of any reportable breach to HHS’ Office of Civil Rights and sending notification letters to affected individuals without unreasonable delay and no later than 60 days after discovery of the breach.

In 2010, after decades of debate and lagging behind many other developed nations, the United States passed a comprehensive healthcare act named the Affordable Care Act of 2010 (a.k.a., Obama Care). Despite all the legislative issues, legal challenges and political attacks on this law, Obama Care is here to stay and we should begin thinking about how it affects our everyday lives and how to comply with its requirements.

Affordable Care Act of 2010, also known as the Obama Care, imposes certain requirements on businesses with respect to whether and how a business is required to provide healthcare insurance to its employees. The majority of the requirements imposed by Obama Act apply only to large businesses and those small businesses which offer healthcare to its employees.

The Stark Law is primarily set forth in section 1877 of the Omnibus Budget Reconciliation Act of 1989 (OBRA 1989). This law prohibits physicians from referring Medicare patients to an entity for designated health services (DHS), if the physician or the physician’s immediate family has a financial relationship with the entity.