Author: WadeEmmert

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Health Law Highlights

Texas Supreme Court Declines Opportunity to Hear Personhood Case

Summary of article from Epstein Becker Green, by Erin Sutton:

The Texas Supreme Court has declined to review the case Antoun v. Antoun, which sought to establish whether frozen embryos are considered persons or property under Texas law. The case arose after a divorce trial awarded the couple’s frozen embryos to the husband, based on their in vitro fertilization (IVF) consent form. The wife argued that under Texas’s total abortion ban, the embryos should be treated as human beings, not property, which would necessitate a different standard for determining “custody”. Despite this, the Court denied the review without comment. The decision may influence future legislation and court decisions regarding the personhood status of embryos, particularly in states with policies recognizing embryos as “unborn children”.

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Health Law Highlights

Fort Worth Physicians Assistant Sentenced in Medicare Fraud Case

Summary of article from WFAA, by Ben Sawyers:

North Texas physician’s assistant, Ray Anthony Shoulders, was sentenced to seven years in federal prison on counts of healthcare fraud, after submitting $788,000 in fraudulent medical claims and receiving over $614,000 in Medicare reimbursements. Shoulders was found to be injecting patients with amniotic fluid, a non-FDA approved treatment, under the guise of pain management. He manipulated billing codes to claim reimbursements from Medicare, using codes for an approved product while actually using a non-approved one. The scam, which operated intermittently between August 2020 and October 2021, resulted in significant profits for the clinic. Shoulders was ordered to pay $614,235 in restitution.

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Health Law Highlights

Justice Department Unseals Documents in Texas Children’s HIPAA Violation Case

Summary of article from Becker’s Hospital Review, by Naomi Diaz:

The U.S. Justice Department unsealed documents concerning Dr. Eithan Haim, who is accused of violating the Health Insurance Portability and Accountability Act (HIPAA) by illegally accessing and leaking internal documents from Texas Children’s Hospital. The documents pertained to gender-affirming services and included patients’ personal health information. Dr. Haim allegedly obtained this information with the intent to cause harm to the hospital. He shared these documents with a senior fellow at the Manhattan Institute, in May 2023. If convicted, Dr. Haim could face a maximum of 10 years in federal prison and a fine of up to $250,000.

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Health Law Highlights

Credentialing Is Burdening Small Hospitals—and Underserved Communities Pay the Price

Summary of article from HealthExec, by Chad Van Alstin:

The credentialing process in healthcare, which verifies a provider’s education, training, licenses, and professional experience, is a time-consuming manual task, especially burdensome for small hospitals and independent practices. The lack of a centralized data repository and varying state regulations complicate the process, with no current way to automate it due to the need for data from hundreds of disparate sources. This process can delay the hiring of healthcare providers, impacting patient care, especially in underserved communities. Solutions like blockchain have been explored but are met with skepticism due to issues of data reliability and technical limitations. Until a more efficient system is found, the credentialing process remains largely manual, leading to increased time and labor costs, particularly affecting rural and underserved areas.

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Health Law Highlights

Importance of Negotiating Holdover Provisions in Health Care Leases

Summary of article from Epstein Becker & Green, by Zlata Fayer, Allison Zangrilli:

Negotiating holdover provisions, clauses that account for situations when a tenant remains in the property after lease expiration, is crucial in health care leases. Tenants who fail to vacate on time face holdover rental rates which can be up to double the agreed monthly rent. Therefore, tenants should negotiate these provisions to ensure a reasonable holdover rental rate. They may also aim for a grace period with an unchanged base rental before the holdover rate comes into effect. This negotiation can help tenants limit their liability in unforeseen circumstances that prevent them from vacating the premises on time.

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Health Law Highlights

As Federal Healthcare AI Regs Stall, States Take Matters Into Own Hands

Summary of article from Medical Marketing & Media, by Lecia Bushak:

States such as Colorado and California are introducing legislation to regulate the use of Artificial Intelligence (AI) in various sectors, including healthcare, in response to the lack of federal regulation. Colorado’s Governor signed SB 205, the first comprehensive AI bias law in the nation, which aims to regulate the use of AI in high-stake decisions and prevent discriminatory use based on genetic information or other data. California is pushing forward approximately 30 regulatory measures to establish boundaries around AI technology, building upon its 2020 data privacy law. Across the US, around 400 new laws on AI have been proposed this year, reflecting the growing legislative interest in the area. Despite some draft legislation at the federal level, experts do not anticipate federal regulation on AI to be established in the near future.

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Health Law Highlights

Can ChatGPT Be Trusted to Provide Medication Information to Patients?

Summary of article from Drug Topics, by Lauren Massaro:

A study published in the Journal of the American Pharmacists Association has found that while AI chatbot, ChatGPT, can provide correct answers to common medication questions, it may not always provide complete information. The study evaluated ChatGPT’s responses to questions about the top 20 drugs, and found that 92.5% of responses were completely correct, but only 80.8% were complete. The study also found inconsistencies in the chatbot’s responses when the same questions were asked again after two weeks. Despite these limitations, the authors believe AI chatbots have potential as healthcare tools, but stress the importance of patients validating information with healthcare professionals. They also highlight the need for robust regulatory frameworks, fact-checking mechanisms, and increased public education about health literacy and responsible use of AI.

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Health Law Highlights

Tips to Shorten Healthcare’s Cybersecurity Learning Curve

Summary of article from Healthcare IT News, by Andrea Fox:

Healthcare organizations are struggling with cybersecurity, especially as threats become more sophisticated. Traditional endpoint detection and response systems are proving inadequate, with many able to be bypassed without triggering alerts. Healthcare organizations have unique blind spots due to reliance on basic security measures and a complex digital infrastructure. Artificial intelligence can aid in identifying and responding to threats in real-time, but AI is a tool, not a magic solution. Healthcare organizations and third-party vendors need to adopt advanced threat detection and response technologies, and act as a united front to better resist cyberattacks.

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Health Law Highlights

What to Learn From DOJ’s First Telehealth-Prescribed Controlled Substances Case

Summary of article from Husch Blackwell, by Jonathan Porter:

On June 13, 2024, the Justice Department arrested two executives of Done Global Inc., a digital health company, marking the first criminal case against telehealth executives for allegedly causing illegal prescriptions of controlled substances. The charges include a drug dealing conspiracy, a healthcare fraud conspiracy, and obstruction of justice. Key lessons from the case include the importance of adherence to state and federal laws when prescribing controlled substances via telehealth, the risks of restricting prescribers’ access to patients and incentivizing prescriptions without follow-up evaluations, and the potential for prosecution under a drug-dealing conspiracy rather than the Anti-Kickback Statute. The case also highlights the potential challenges of proving such charges, particularly in light of the 2022 Supreme Court Ruan case, and the illegality and risks of deleting documents during an investigation. Despite this case, telehealth remains a valuable practice, but healthcare innovators should be mindful of the risks associated with restricting the physician-patient relationship.

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OIG Testimony Puts a Spotlight on Clinical Documentation and Payer Risk

Summary of article from Ankura, by Emily Petersen:

In a recent testimony, the Inspector General of the Department of Health and Human Services (HHS), highlighted issues surrounding risk adjustment in Medicare Advantage (MA) and proposed stricter rules for diagnoses used in risk adjustment calculations. She underscored the issue of rising improper payments within Medicare and Medicaid, emphasizing the need for increased oversight and enforcement. Significant vulnerabilities in the MA risk adjustment process and challenges in Medicaid Managed Care were also discussed, with a call for organizations to review their medical records and ensure the accuracy of diagnosis codes. Furthermore, systemic weaknesses such as eligibility determination errors and duplicate payments were pointed out, requiring urgent attention. Lastly, Grimm emphasized the need for increased investment in oversight and enforcement to combat fraud, waste, and abuse in healthcare programs.