Stories in New York and across the country seem to surface just about every day to underscore -- as we note on our health care law website at Daniels, Porco & Lusardi, LLP -- that, "Within the health care arena, every legal matter comes with layers of regulatory and compliance issues that must be addressed."
Recent New York-based news relevant to the health care industry bears special significance for one emerging class of participants in that realm, on at least two material fronts.
One commentator in a recent national media focus on medical actors being targeted in criminal and civil investigations refers to "a new permutation" that is well worth noting in the health care industry. He calls it "the beginning of the next round" for what might be in store for legions of medical industry participants, ranging from pharmaceutical drug makers and wholesale manufacturers to pharmacies and other entities.
If you are a covered entity in any matter involving the federal Health Insurance Portability and Accountability Act of 1996 (HIPPA), you might derive some comfort from knowing that the legislation does not provide for a private right of legal action against you for any alleged wrongdoing under that law.
We have stressed in many prior blog posts the singular nature of the health care industry across many dimensions, including, centrally, the realm's uppercase concern with this constant and ever-growing threat: attacks by hackers aimed at medical actors' proprietary and most confidential data.
Imagine that you -- like virtually all your peers -- are a participant within the sprawling American medical industry who merely seeks to go about your job on a daily basis in a conscientious and ethical manner.
It hardly equates to a news event these days to note that health care costs are a material concern to scores of millions of people across the country, including high numbers of New York residents.
Unquestionably, we live in an age of cutting-edge and quickly evolving technologies, with that reality transforming life in fundamental ways.
According to the Kaiser Family Foundation, Medicare spending for 2016 is expected to reach $560 billion and is projected to continue to increase exponentially with Medicare spending costs soaring to $866 billion by 2024. If these projections are accurate, there's growing concern among many economists that the Medicare program will soon be insolvent.
The complex nature of billing practices within the health care field makes it particularly vulnerable to errors and possible acts of fraud. In cases where a hospital or nursing home employee believes that an employer is engaging in dishonest financial practices aimed to defraud the federal government, a lawsuit may be filed under the False Claims Act.