Massachusetts executive agencies have been issuing an array of further guidance to the healthcare provider community regarding COVID-19. All orders and guidance are available at https://www.mass.gov/2019coronavirus. Review of this website and CDC websites for periodic updates is strongly encouraged, as the situation is fluid and continually evolving.
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Massachusetts
Recent Anti-Kickback Cases Emphasize Government Scrutiny of Speaker’s Bureaus and Lavish Meals Funded by Pharmaceutical and Device Manufacturers
By Conor Duffy on
The Department of Justice (DOJ) recently resolved two health care fraud cases – one criminal and one civil – that demonstrate the government’s continued scrutiny of lavish meals and “speaker’s bureaus” sponsored by pharmaceutical and device manufacturers as potential avenues for the payment of kickbacks to physicians for referrals of health care items and services. These cases indicate the criminal and civil risk that providing lavish meals or purported speaker’s bureau payment can pose, and the corresponding need to proactively assess the legitimacy of such programs and events.
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Massachusetts’ Health Policy Commission Further Limits Health Care Cost Growth
On March 29, 2017, the Massachusetts Health Policy Commission voted to decrease its annual health care cost growth benchmark from 3.6 percent to a 3.1 percent, effective in 2018. The benchmark applies to hospitals, certain physician groups and individual health insurers. The Commission also voted to finalize regulations to require those entities that fail to comply with the benchmark to file and follow performance improvement plans. Non-compliant entities will be subject to oversight by the Commission, during which they will be required to file monthly progress reports and demonstrate that they are taking steps to slow their cost growth. The regulations also authorize the Commission to assess civil penalties against non-compliant entities in certain circumstances, such as when an entity willfully neglects to file a required performance improvement plan.
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Massachusetts Issues Mass HIway Regulations
By Nathaniel Arden on
Massachusetts recently released a final regulation concerning its health information exchange, which became effective February 10, 2017. Under this regulation, Provider Organizations are required to connect to Massachusetts’ statewide health information exchange known as the Mass HIway. Provider Organizations include Massachusetts acute care hospitals, community health centers, and medical ambulatory practices. These regulations continue the push toward increased interoperability of patient medical records across health care providers, in an effort to improve the ability of a provider to see the full medical picture of a patient.
Provider Organizations must connect to the Mass HIway over the course of a four year phased-in timeline. For acute care hospitals, year one begins on February 10, 2017. For all other Provider Organizations except small community health centers, year one begins on January 1, 2018. Small community health centers’ first year begins January 1, 2019. Provider Organizations must “connect” to the Mass HIway during each applicable year as follows:
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