OCR Announces HIPAA/COVID-19 Vaccination Enforcement Discretion

The Department of Health and Human Services Office for Civil Rights (“OCR”) announced that it will exercise its enforcement discretion not to impose penalties against covered health care providers or their business associates for certain violations of the Health Insurance Portability and Accountability Act (“HIPAA”) in connection with the good faith and limited-purpose use of online or web-based scheduling applications for the scheduling of individual COVID-19 vaccination appointments during the ongoing COVID-19 public health emergency.  This enforcement discretion is immediately effective and has retroactive effect to December 11, 2020.  More information can be found here.

 

DOJ Announces False Claims Act Fraud Recoveries for 2020

The Department of Justice (“DOJ”) announced the recovery of more than $2.2 billion in settlements and judgments from False Claims Act cases during fiscal year 2020.  Of this recovered amount, more than $1.8 billion related to matters involving various sectors of the health care industry, such as hospitals, laboratories, pharmacies, hospice organizations, drug makers, medical device manufactures, and individual physicians.  This $1.8 billion recovery reflects only fraud and false claims against federal health care programs; the DOJ also assisted in the recovery of tens of millions of dollars for state Medicaid programs.

 

CMS Releases Notice of Benefit and Payment Parameter Rule

The Centers for Medicare & Medicaid Services (“CMS”) released a notice of benefit and payment parameters final rule that implements payment and other regulatory provisions regarding network adequacy standards for certain health plans, the acceptance of payments by Qualified Health Plan issuers, and user fees for federally-facilitated exchanges and state-based exchanges on the federal platform.  This final rule also introduces a new direct enrollment option for the aforementioned exchanges.

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