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Regulatory Developments
Medicare Providers' Progress with HIPAA: Good or Bad?
Are Medicare Part A providers meeting standards imposed by the Health Insurance Portability and Accountability Act of 1996 (HIPAA)? On May 2003, the Office of Evaluations and Inspections (OEI), Office of the Inspector General (OIG), Department of Health and Human Services (HHS) issued a report about the progress made by Medicare Part A providers in meeting various standards imposed by HHS as part of HIPPA implementation. See HIPAA Readiness: Administrative Simplification for Medicare Part A Providers (OEI-09-02-00421). As explained in the report, this study was conducted 'to determine if Medicare Part A providers expect to comply with the electronic data transaction standards and code sets mandated by ' [HIPAA] by October 2003. HIPAA Readiness ' Executive Summary, at 1. As part of its obligations under HIPAA, HHS promulgated regulations requiring that specific standards be used for eight different types of electronic transactions and medical code sets by October 16, 2003. See 45 C.F.R. Parts 160 and 162. The eight types of electronic transactions are:
- Health care claims or equivalent encounter information;
- Health care payments and remittance advice;
- Coordination of benefits;
- Health care claim status;
- Enrollment and disenrollment in a health plan;
- Eligibility for a health plan;
- Health plan premium payments; and
- Referral certification and authorization.
To determine how many providers expect to be ready to comply with this deadline, the OEI evaluated the results of a mail survey of a stratified random sample of Medicare Part A providers that submitted claims to Medicare fiscal intermediaries between July 1, 2001 and June 30, 2002. Id. The results from this sample are promising: Ninety-two percent of Part A providers report having made significant progress in meeting the HIPAA deadline, while another one-half are developing sequencing strategies and contingency plans in the event their system is not fully in compliance with the deadline. Id. at 1-2. The report can be obtained from the OIG's Web site, www.oig.hhs.gov/
The DOJ's Corporate Enforcement Policy: One Year Later
The DOJ's Criminal Division issued three declinations since the issuance of the revised CEP a year ago. Review of these cases gives insight into DOJ's implementation of the new policy in practice.
Use of Deferred Prosecution Agreements In White Collar Investigations
This article discusses the practical and policy reasons for the use of DPAs and NPAs in white-collar criminal investigations, and considers the NDAA's new reporting provision and its relationship with other efforts to enhance transparency in DOJ decision-making.
The DOJ's New Parameters for Evaluating Corporate Compliance Programs
The parameters set forth in the DOJ's memorandum have implications not only for the government's evaluation of compliance programs in the context of criminal charging decisions, but also for how defense counsel structure their conference-room advocacy seeking declinations or lesser sanctions in both criminal and civil investigations.
CLE Shouldn't Be the Only Mandatory Training for Attorneys
Each stage of an attorney's career offers opportunities for a curriculum that addresses both the individual's and the firm's need to drive success.
Discovery of Claim Construction and Infringement Analysis May be Compelled Prior to a Markman Hearing
A defendant in a patent infringement suit may, during discovery and prior to a <i>Markman</i> hearing, compel the plaintiff to produce claim charts, claim constructions, and element-by-element infringement analyses.