Category: Health Law Highlights

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Health Law Highlights

Federal District Court Finds Private-Insurer Relator Can Proceed with False Claims Action

Summary of article from The FCA Insider, by Michael Podberesky, Brett Barnett, Stephen Tagert:

The U.S. District Court for the District of New Jersey allowed Allstate Insurance Company to proceed with its whistleblower action against Phoenix Toxicology and Lab Services, LLC, alleging the submission of false claims for unnecessary urine drug tests to federal programs. This case highlights a trend of non-traditional whistleblowers, such as private insurers and litigation-funding groups, increasingly bringing False Claims Act actions. The ruling underscores the importance for healthcare providers to be vigilant about potential fraud detection by both insiders and external parties. This decision also illustrates the growing role of the Department of Justice in addressing fraudulent activities related to the opioid epidemic and federal healthcare programs.

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Health Law Highlights

Six Months to Go: HIPAA Privacy Rule Changes Require Additional Diligence

Summary of article from Taft Privacy & Data Security Insights, by Scot Ganow:

The Department of Health and Human Services (HHS) has issued final regulations modifying the HIPAA Privacy Rule to protect individuals’ reproductive health information, effective June 25, 2024, with compliance required by December 23, 2024. These changes prohibit HIPAA-regulated entities from disclosing protected health information (PHI) for purposes of investigating or imposing liability for lawful reproductive health care. Additionally, the regulations establish a presumption of lawfulness for reproductive care and mandate obtaining signed attestations for certain disclosures. HIPAA-covered entities and business associates must update their policies, procedures, agreements, and training to align with these new requirements. Notices of privacy practices must also be revised by February 16, 2026.

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Health Law Highlights

Healthcare Scores a B for Cybersecurity

Summary of article from The HIPAA Journal, by Steve Adler:

SecurityScorecard awarded the U.S. healthcare industry a B+ cybersecurity rating for the first half of 2024, despite significant breaches, including a major ransomware attack on Change Healthcare. The study assessed the top 500 publicly traded healthcare companies, revealing a mean security score of 88. Medical device manufacturers and suppliers had the lowest security scores within the sector, largely due to their extensive attack surfaces. Key areas for improvement include application security, DNS health, and network security, with common issues such as weak SSL/TLS protocols and outdated web browsers. Recommendations for enhancing security emphasize third-party risk management and improved application and endpoint security practices.

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Health Law Highlights

Cyber Attacks on Health Care Up 136% Last Year

Summary of article from Medical Economics, by Grace Koennecke:

In 2023, the US experienced a significant rise in data breaches, with 3,205 incidents reported, marking a 78% increase from 2022. The healthcare industry saw a 136% increase in data breaches, affecting 56 million individuals, while the financial services sector experienced a 177% rise, impacting 61 million people. The Identify Theft Resource Center recommends the healthcare sector adopt stronger breach notice laws and improve vendor due diligence to mitigate cyber threats.

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Health Law Highlights

“Wheels Fall Off” FTC’s Latest Hospital Merger Challenge

Summary of article from Holland & Knight LLP, by Bill Katz, David Kully, Krithika Rajkumar:

The Judge in FTC v. Community Health Systems Inc. & Novant Health Inc., denied the FTC’s motion to block Novant Health’s $320 million acquisition of two hospitals, marking a rare loss for the FTC in hospital merger challenges. The ruling revitalized the “failing firm” defense, suggesting that the assets in question would cease to be competitive without the merger, despite not meeting the stringent criteria outlined in the Merger Guidelines. The court acknowledged potential harm to competition but emphasized that the acquisition would likely enhance investment and competition in the Charlotte area. The FTC has appealed the decision, with the application of the failing firm defense expected to be a key issue. This case may influence future hospital mergers involving financially distressed entities.

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Health Law Highlights

For All Intents and Purposes the Ninth Circuit Shakes Up Antitrust Law With Sidibe v. Sutter Decision

Summary of article from Proskauer Rose LLP, by David Munkittrick, Evelyn Blanco:

The Ninth Circuit Court’s decision in Sidibe v. Sutter Health may significantly alter the approach to rule of reason antitrust cases by emphasizing the importance of historical evidence and the intent behind challenged conduct. The court reversed the District Court’s ruling due to the exclusion of pre-2006 evidence and errors in jury instructions, which failed to consider Sutter Health’s purpose. The majority opinion argued that understanding the intent is crucial for a comprehensive assessment of antitrust claims, while the dissent warned against overcomplicating trials with extensive historical context. This ruling suggests a potential shift towards incorporating intent more prominently in antitrust analyses, raising questions about trial complexity and jury management. Legal professionals will need to adapt to these changes to effectively advocate in antitrust cases.

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Health Law Highlights

How Artificial Intelligence Is Changing Diabetes Care

Summary of article from DiaTribe, by Michael Howerton:

Experts at the ADA 2024 Scientific Sessions highlighted AI’s potential to revolutionize clinical practice through applications like automated insulin delivery and AI-augmented clinical trials. While the benefits are substantial, concerns about data security and privacy must be addressed to ensure wider adoption. AI’s integration into diabetes care promises to empower patients with more control and knowledge about their condition. The continued development of AI-driven systems and safeguards will be crucial in realizing these advancements.

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Health Law Highlights

Healthcare Chatbots: When Do They Help and When Do They Hurt?

Summary of article from Built In, by Alexandra Whitt:

Healthcare chatbots offer significant benefits, including improved user engagement, quick responsiveness to minor health queries, reduced administrative workload, enhanced customer satisfaction, and better advocacy for health and wellness programs. They streamline processes such as appointment scheduling and insurance claims, providing 24/7 access to critical information. However, chatbots face limitations like lacking empathy, potential for incomplete assessments, data security risks, and the overwhelming variety of options available. While they enhance efficiency and accessibility in healthcare, it is crucial to recognize their limitations and ensure they complement rather than replace professional medical advice.

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Health Law Highlights

Three Key Areas Where Healthcare IT Leaders Can Deploy AI to Improve Patient Outcomes

Summary of article from CIO, by John Cox:

Healthcare IT leaders can deploy AI to improve patient outcomes in three key areas: fully utilizing patient-related data, personalizing the patient experience, and easing administrative burdens on healthcare professionals. By consolidating patient data with tools like Microsoft Azure, AI can create a standardized data source, enhancing data analytics and compliance. Personalization can be achieved by leveraging AI to integrate disparate data, improving patient interactions and care processes. Additionally, AI can automate routine administrative tasks, allowing healthcare professionals to focus more on patient care. Partnering with experienced IT solutions providers can expedite these AI implementations and support future advancements.

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Health Law Highlights

Modernizing and Securing Hospital Technology Infrastructure

Summary of article from MedCity News, by Derek Grant:

The healthcare industry is undergoing a significant digital transformation, necessitating the modernization of technology infrastructure to improve patient outcomes and operational efficiency. Budget constraints and the complexity of integrating diverse systems across merged hospital networks pose significant challenges. Prioritizing security is critical, with a comprehensive strategy encompassing Zero Trust, data protection, and compliance frameworks to mitigate cyber threats. Effective data governance and the adoption of AI-based solutions can enhance decision-making, operational efficiency, and security. Ongoing cybersecurity training and a culture of vigilance are essential to protect sensitive medical data and maintain patient trust.