Feds Fine Compliance Officer $1 Million, Highlighting Major Risks

By | March 10, 2015

The U.S. Attorney’s Office for the Southern District of New York is seeking a $1 million fine from a compliance officer in connection with a criminal case against his former employer, which paid $100 million in 2012 for a fraud scheme. While the officer was not working in a health care organization, the case highlights the perils health care compliance […]


Caulfield and Ullrich present at LeadingAge Colorado Policy Forum

By | March 9, 2015

BOULDER—March 9, 2015—Caplan and Earnest health care law attorneys Sharon Caulfield and Matt Ullrich recently presented at the LeadingAge Colorado 2015 Policy Forum. They presented to members on legislative health care law updates, handling marijuana issues, integrating LGBTQ residents and elder law matters. LeadingAge Colorado is the state’s largest association representing and advocating for senior living and care providers.

 

Caulfield’s practice […]


Federal Court Opinion Is a Reminder that Antitrust Concerns Are Alive and Well

By | March 3, 2015

There is a wide round of discussion about consolidation in the health care field in order to meet the updated health care system that is anticipated under the Affordable Care Act. Health care providers are looking to consolidate through joint ventures and mergers, so that they may have the presumed efficiencies of larger organizations and a wider range of providers for […]


Half of Medicare Payments to Shift to Alternative Models by 2019

By | February 2, 2015

In news that affects hospital providers, the United States Department of Health and Human Services recently set goals and a timeline for shifting half of Medicare payments by 2019 to alternative models that are based on the quality, not quantity, of care that providers give patients.

HHS set the goal of tying 30 percent of traditional Medicare payments to quality through […]


Texting Patient Information: BTW, Do U Know the Risks?

By | January 13, 2015

Cindy Pechon also contributed to this post.

Does HIPAA allow health care providers to text protected health information (“PHI”) within an organization or to another health care provider? It is not expressly prohibited by HIPAA, but whether it is safe mostly depends on the adequacy of the controls used to safeguard PHI. Covered Entities, including health care providers, must comply with […]


Three Caplan and Earnest Attorneys Named to 5280 Magazine’s Top Lawyers List

By | January 13, 2015

BOULDER—Caplan and Earnest LLC health care law attorneys Linda Siderius, Sharon Caulfield and Jennifer Sullivan were named a 2015 “Top Lawyer” in 5280 Magazine’s debut listing of Denver’s best attorneys. The attorneys were three of only nine health care law attorneys honored in the magazine.

The listing includes 350 attorneys overall and is based on a rigorous peer-review process in addition […]


CMS Home Health PPS changes take effect Jan. 1

By | December 22, 2014

After proposing changes to the Medicare Home Health Prospective Payment System for 2015 this summer and receiving feedback in October, the Centers for Medicare & Medicaid Services (CMS) is set to implement the rule change on January 1, 2015. The HH PPS payment rates include continued implementation of the rebasing adjustments as required by the Affordable Care Act (“ACA”).

Some home […]


CMS Scrutinizing Hospital Use of New Modifier for ‘Clinically Unrelated’ Lab Billing

By | December 2, 2014

Officials from the Centers for Medicare and Medicaid Services announced recently that they are monitoring compliance in the use of the new L1 modifier when billing separately for “clinically unrelated” lab tests.

Use of the new modifier became effective July 1 and is intended for claims that are an exception to the typical Medicare packaging policy created for most outpatient lab […]


5280 Magazine Names Sharon Caulfield as Top Lawyer

By | September 15, 2014

BOULDER—Attorney Sharon E. Caulfield of Caplan and Earnest LLC was named a 2015 “Top Lawyer” by 5280 magazine in their debut listing of Denver’s best attorneys. Caulfield specializes in health care law.

The listing includes 350 attorneys and is based on a rigorous peer-review process in addition to research by the magazine’s editors.

Caulfield’s practice focuses on regulatory compliance and litigation for […]


Health Care and the 2014 Colorado Legislative Session

By | July 17, 2014

The 2014 Colorado Legislative Session resulted in some key pieces of health care legislation, thanks in part to the improving economy, which allowed the legislature to address several long-term needs in the state’s health care system.

Those needs included developing a strategic plan for enrolling intellectually and developmentally disabled persons into programs; encouraging in-home support services for persons with spinal cord […]