Southern District of New York Reaffirms that ERISA Does Not Completely Preempt Out-of-Network Providers’ State Law Claims Against Health Plan Administrators Based on Pre-Service Promises of Payment Jenkins v. Aetna Health Inc., No. 23 Civ. 9470, 2024 WL1795488 (S.D.N.Y. Apr. 25, 2024). Plaintiffs, including a neurosurgeon and his private practice, brought this action against Aetna, … Continued

A few Reproductive and/or Maternal Health Legal Highlights: On April 26, 2024, the Office for Civil Rights of the United States Department of Health and Human Services published in the Federal Register the Final Rule (Rule) regarding reproductive health privacy rights. The Rule is entitled “HIPAA Privacy Rule to Support Reproductive Health Care Privacy;1 the effective … Continued

“Of all forms of inequality, injustice in health care is the most shocking and inhuman” Dr. Martin Luther King, Jr. at the National Convention of the Medical Committee on Human Rights, Chicago 1966 In its 2020 Call to Action, the American Heart Association declared that structural racism has been and remains a fundamental cause of … Continued

Introduction Despite great advancements in modern medicine, including obstetrics and gynecology, in the United States, the maternal mortality rates remain surprisingly high. The World Health Organization defines a pregnancy-related death as: “the death of a woman while pregnant or within 42 days [(about 1.5 months)] of termination of pregnancy, irrespective of the cause of death … Continued

I. Introduction to the Topic A physician employment contract is a detailed document that covers a physician’s compensation and expected duties and responsibilities to a prospective employer.1 It typically outlines the type of medicine to practice, the number of hours a physician is expected to work, availability, on-call hours, and outpatient care or administrative duties.2 For this … Continued

On November 13, 2023, New York Governor Kathy Hochul announced the release of proposed statewide hospital cybersecurity regulations that would require state-licensed hospitals to establish cybersecurity programs, policies and procedures (the “Proposed Regulations”).1 The Proposed Regulations feature requirements regarding cybersecurity policies and procedures, personnel, user authentication methods, security risk assessments, incident response plans, and two-hour reporting … Continued

New York State Department of Health Medicaid Decisions Compiled by Ron L. Oakes NewCo ALP, Inc. d/b/a Island Assisted Living (Decision After Hearing, December 11, 2023, John Harris Terepka, ALJ). Appellant operates an Assisted Living Program (ALP) in Hempstead, N.Y. The New York State Office of the Medicaid Inspector General (OMIG) audited appellant’s reimbursement from … Continued

Over the last four years there has been a 239% increase in significant hacking breaches in the health care industry.1 There was a 60% increase in the number of Americans impacted by breaches of their personal health information in 2023 alone.2 The cybersecurity firm Sophos recently found that globally, nearly two-thirds of health care organizations were victims … Continued

Annual Meeting Kudos to Margaret J. Davino, Fox Rothchild, LLP and Daniel Weinstein, Manatt, Phelps & Phillips, LLP for another successful Annual Meeting on “Emerging Issues in Health Care.” One of the highlights of the meeting was a presentation on CMS/CMMI new innovation models by Elizabeth Fowler, Ph.D., J.D., Deputy Administrator and Director of the Center for … Continued

Testing by clinical laboratories is governed by myriad federal and state statutes, regulations, and administrative guidance. Laboratories are required to be licensed under the Clinical Laboratory Improvement Amendments of 1988 (CLIA). In New York, laboratories meet CLIA requirements by receiving a valid New York State permit because New York was granted exempt status by the … Continued