Clinical Integration and ACO Alert 

News and Information from Broad and Cassel's Health Law Practice Group

January 2013
Volume 3, Issue 1
BREAKING NEWS
HHS releases update to HIPAA privacy and security rules. 

Practice Group Update

Featured Authors

 

Mike Segal

Partner

MSegal@BroadandCassel.com 

305.373.9400

View Bio  

 

  

Heather Miller (New) 

Heather S. Miller

Senior Counsel

HMiller@BroadandCassel.com 

305.373.9400

View Bio 

 

 

Fred Segal

Associate

FSegal@BroadandCassel.com 

305.373.9400

View Bio 

   

 

Stephen Siegel

Stephen Siegel

Of Counsel

SHSiegel@BroadandCassel.com 

305.373.9400

View Bio  

    

 

Ramona Thomas  

Ramona Thomas

Associate

RHThomas@BroadandCassel.com

305.373.9400

View Bio 

 About Us
Broad and Cassel offers full-service legal representation for individuals, public entities and private enterprises--from start-ups to Fortune 500 companies. Founded in 1946, we have office locations throughout the state to serve your legal needs. 

With more than 20 attorneys and a full complement of support staff, Broad and Cassel's Health Law Practice Group is intimately aware of the complex issues faced by health care providers, suppliers and consumers. 

Fundamental changes to the nation's health care delivery system are occurring at an accelerated rate, requiring those in the industry to establish and refine their practices and policies to comply with new regulations. The attorneys of our Health Law Practice Group are prepared to discuss these changes and the potential impact they will have on health care providers of all types.   
 

 LOGO

 

www.BroadandCassel.com  

To all our clients and friends,

President Obama's reelection assures that, for better or worse, Obamacare will be upon us in full force by 2014.  Now is the time to be planning - and acting.  The health care attorneys at Broad and Cassel are very focused on all the many nuances of the law.  We are writing and speaking about it all over the country.  In this bi-monthly alert we try to provide you with relevant and important information to help you cope with all the changes that are upon us.  I hope you enjoy!

Mike Segal

Chair, Health Law Practice Group

 Four Broad and Cassel Attorneys Pen Chapter in National Health Law Book

Mike Segal, Heather S. Miller, Stephen H. Siegel and Fred Segal of Broad and Cassel's Health Law Practice Group collaborated on a chapter for the 2013 Health Law and Compliance Update, which was published this month by Aspen Publishers.

 

The chapter, entitled "Medicare Certified Accountable Care Organizations," explains the history of the formation of Accountable Care Organizations (ACOs) and provides a thorough explanation of the steps necessary to plan and implement an ACO. Topics covered include the Medicare Shared Savings Program, federal antitrust rules and their effect on ACOs, health information technology, ACO tax issues and state law issues.

 

In its 10th year of publication, the 2013 Health Law and Compliance Update provides readers with the latest information on emerging issues in health law and health care compliance. Each chapter is written by knowledgeable and experienced professionals from health care organizations and law and consulting firms. The following topics are included in addition to the ACO chapter: compliance-related tax issues, evolution of stroke affiliate programs, Medicare benefits and coverage, delivering effective health care security, compliance program monitoring and auditing methods and techniques.

 

The 2013 Health Law and Compliance Update may be purchased on the following websites:

Aspen Publishers 

Amazon 

 

Cynthia Barnett Hibnick Joins Broad and Cassel's Health Law Practice Group 

We are pleased to announce that attorney Cynthia Barnett Hibnick has joined the Miami office of Broad and Cassel as Of Counsel in the Firm's Commercial Litigation and Health Law Practice Groups.

Hibnick was previously a shareholder with Cynthia Barnett Hibnick, P.A. An AV-rated attorney with more than 29 years of jury trial experience in state and federal courts throughout Florida, her diverse portfolio of experience includes medical and professional liability defense, regulatory and administrative claims defense, peer review, credentialing/privileges assistance and dispute resolution, business planning and strategizing, general business litigation and dispute resolution, litigation and litigation support, business and health-related issues. 

Hibnick is a graduate of the University of Miami, magna cum laude, and received her juris doctor, cum laude, from the University of Miami School of Law.  

 

 Please click here to view her attorney profile. 

Even small HIPAA breaches can prove costly

By: Stephen Siegel

On January 2, 2013, the HHS Office of Civil Rights announced that it had settled a HIPAA breach case involving electronic health information of 441 patients of the Hospice of North Idaho. The settlement amount, $50,000, represents the first HIPAA breach settlement involving less than 500 patients.

 


Consequences and Rewards for an Employer's Decision to Provide Health Insurance  
By: Fred Segal

On March 23, 2010, President Obama signed into law the Patient Protection and Affordable Care Act (P.L. 111-148) (i.e. "PPACA" or "Obamacare"). One of the main purposes of this health reform law is to expand healthcare coverage for all citizens. According to the Kaiser Family Foundation, Employer-Sponsored health insurance is the primary source of Health Insurance in the United States and as recently as 2008, "80% of the uninsured have some connection to the workforce."[1] PPACA's goal is to have employers and the government "work together" to expand coverage. Thus, PPACA targets employer-sponsored insurance to try and reach more uninsured citizens. As a result, PPACA contains "pay-or-play" requirements that incentivize certain employers that offer affordable coverage for its employees, and penalizes certain employers who don't offer affordable coverage.

Please click here to continue reading.


[1] EXPLAINING HEALTH CARE REFORM: What Is An Employer 'Pay-or-Play" Requirement?, Kaiser Family Foundation, May 2009, available at http://www.kff.org/healthreform/upload/7907.pdf

Quality assurance outside of the hospital setting
By: Ramona Thomas

The Credentialing Resource Center Journal, which is a go-to source for privileging white papers and medical staff credentialing guidance, recently published an article on group-based peer review (as opposed to hospital-based peer review/professional practice evaluation).  T
he article helps to highlight the differences between legal/regulatory requirements and "best practices."  Effective peer review helps to protect against claims of negligent credentialing and works toward achieving risk management and patient safety goals.

 

In many states, including Florida, licensed facilities, including hospitals, are required to conduct peer review in order to ensure that the facility's medical staff includes only competent, well-qualified practitioners.  In Florida, the same requirement is not currently imposed on organized physician practice groups.  However, the fact that a group does not have to conduct peer review doesn't necessarily mean that it should not.  Establishing a group-based peer review process can help foster mutual accountability and cooperation between hospitals or health systems and physician groups.

 

Please click here to learn more.