Nov 2013

Increasing Use of Telemedicine Presents Regulatory Issues

As healthcare providers seek to lower costs and provide services in underserved areas, many are looking to technology and the growing use of telemedicine.

Telemedicine is the remote delivery of healthcare services over a telecommunications infrastructure. With the advance of technology and the introduction of services such as Skype, Tango and FaceTime, it is relatively easy to establish a simultaneous video and voice connection with an individual in a remote location. However, recent disciplinary action taken against an Oklahoma physician who engaged in telemedicine demonstrates that providers should proceed with knowledge and caution in this area.

Oklahoma Physician Disciplined for Treating Patients Via Skype

Until recently, a physician in Oklahoma used Skype to treat patients for pain management issues and prescribed powerful narcotics in the process. The physician’s nurse would travel to various satellite clinics and present the patients to him via Skype. The Oklahoma Health Care Authority, however, disciplined the physician because Skype was not an approved telemedicine communication system. The physician was placed on probation for two years and ordered to complete a course on prescribing practices.

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Sep 2013

2013 Texas Legislative Update

The 83rd Texas Legislature that convened in 2013 went through three special sessions and passed over 1,400 bills.

A large number of these bills are health-related and deal with Medicaid funding. Even though Texas has declined to participate in Medicaid expansion under the Affordable Care Act, the state is still working on its Section 1115 Medicaid waiver, disproportionate share funding and expansion of medical residency programs.

Of special note are a couple of bills that will impact healthcare providers in Texas: (continued)

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Nov 2012

HIPAA Privacy and Security Audits Begin: Enforcement Measures May Follow

The Office for Civil Rights (OCR) of the U.S. Department of Health and Human Services has begun the pilot phase of HIPAA privacy and security audits of health care providers, health insurers and health care clearinghouses (“covered entities”) to assess HIPAA compliance efforts.

While covered entities will be the focus of initial audits, business associates – organizations that provide services on behalf of covered entities and who as a result have access to protected health information (PHI) – will be included in future audits. Up to 150 covered entities will be subject to the initial audits, to be conducted by KPMG, LLP, the OCR audit contractor. Once notified in writing that the entity has been selected to be audited, entities will be required to provide requested information to KPMG, allow an on-site visit, and respond to the auditor’s initial report. Although the OCR says that audits are primarily a “compliance improvement activity,” the OCR may take further action if the audit uncovers serious HIPAA compliance issues. As a result of this audit process, all covered entities and their business associates should review their HIPAA privacy and security practices.

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Mar 2012

Fate of Health Reform is Uncertain After Supreme Court Oral Arguments

After three days of historic oral arguments before the U.S. Supreme Court, the fate of the Affordable Care Act (ACA), the momentous 2010 health reform law, is uncertain, given robust questioning of the ability of Congress to force individuals to purchase health insurance.

During six and a half hours of arguments over three days, the Court heard arguments concerning four questions surrounding the ACA:

• whether the Court has jurisdiction to hear the case under the 1867 Anti-Injunction Act, which prohibits courts from hearing cases involving a tax before the tax is due;

• whether Congress has the power to require individuals to maintain a minimum of health insurance;

• whether the rest of the ACA can remain if the individual mandate is found unconstitutional; and

• whether the expansion of the Medicaid program imposes an undue burden on the states. Given the vigorous questioning of all sides by the Court, observers were left
wondering how the Court will rule. A decision by the Court is expected in late June.

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