Health Care Lawyer Blog

The Michigan Office of Financial and Insurance Regulation (OFIR) has received a $1 million federal grant to help the agency monitor insurance companies who unreasonably hike up the costs of coverage. The funds are part of a $250 million grant allocation provided for by the Patient Protection and Affordable Care Act, and other states will be receiving similar grants to promote oversight of insurance agencies.

Currently, under Michigan law OFIR has the authority to review and approve/reject rate increases proposed by Blue Cross Blue Shield of Michigan. However, OFIR does not have the legislative authority to conduct policy reviews, investigate complaints, or examine insurers. While the grant monies will not change the law, the funds are designed to allow OFIR to contract with consulting actuaries to perform a targeted, in-depth analysis and review of premium filings made by HMOs and commercial carriers.

OFIR will also conduct a study on the feasibility of posting health insurance rate information on a proposed website, and will create a public portal that will provide information to the public in a streamlined, consumer-friendly format. The $1M grant is in addition to funding that will be distributed to the states to help consumers appeal coverage decisions made by health plans and insurance companies.

For more information, visit http://www.healthcare.gov/center/grants/states/mi.html

FHWN attorney Suzanne D. Nolan has published an article detailing the new proposed rule addressing HIPAA security compliance by business associates and subcontractors. The article, which appears in this month's ABA Health Law Section eSource, discusses the provisions of the Health Information Technology for Clinical Health (HITECH) Act that requires business associates - not just covered entities - to directly comply with the security rule.

One important change to the security rule is that now business associate-subcontractor relationships are regulated in the same manner as the covered entity-business associate relationship. This means that business associates of covered entities such as CPAs, attorneys, information technology consultants, etc. who choose to subcontract certain tasks must make sure that the subcontractor will also implement appropriate measures to safeguard protected health information.

For a full summary of the new proposed rules, see Nolan's article available here. For more information pertaining to HIPAA or other health law issues, please contact Sue Nolan or Mercedes Varasteh Dordeski.

The Michigan Supreme Court released an opinion this week that will dramatically change the legal landscape for anyone filing a personal injury claim as a result of automobile negligence or drunk drivers. This entry contains both an overview of the Court’s decision, and an analysis on how it may impact litigation in Michigan.

Background

In McCormick v. Carrier, et al., the Supreme Court overturned a previous 2004 decision holding that Michigan law limited claims for “non-economic damages” to those whose lives were permanently impacted as a result of the accident.

In McCormick, plaintiff Rodney McCormick filed suit after a fellow trucker backed over him and crushed his ankle while he was on duty at a General Motors Plant, where he worked as a medium truck loader. After missing 19 months of work due to the injury, he filed suit and sought recovery for his injuries under MCL 500.3135, which had previously been interpreted to bar any relief for injuries that did not amount to the “serious impairment of body function.”

At trial, the court granted defendant’s motion for summary disposition on the basis that plaintiff had recovered “relatively well” from the injury (although he continued to experience ankle pain and was limited in some of his daily functions) and therefore could not meet the serious impairment threshold provided in MCL 500.3135. This interpretation of MCL 500.3135 was previously set out in Kreiner v Fischer, 471 Mich 109 (2004).

After the jump - Court's reasoning, and analysis of the McCormick decision

Continue reading " Michigan Supreme Court Re-Interprets Standard for Personal Injury Lawsuits " »

The Department of Health and Human Services (“HHS”) has delayed release of the breach notification regulations that covered entities and business associates must adhere to in the event of improper disclosures of protected health information (PHI).

Pursuant to last year’s Health Information Technology for Economic and Clinical Health Act (HITECH), HHS was required to develop regulations governing how covered entities and business associates are required to respond in the event patient PHI is stolen, leaked, or otherwise improperly disclosed. HHS issued an interim final rule on August 24, 2009, which became effective on September 23, 2009. The interim final rule sets out the breach notification standards, such as how to identify if a breach has occurred; who must be notified in the event of a breach; and the manner in which notification must occur.

During the 60-day public comment period on the Interim Final Rule, HHS received approximately 120 comments. After review of the comments, HHS developed a final rule, which was submitted to the Office of Management and Budget (OMB) for regulatory review on May 14, 2010. However, on Friday HHS withdrew the final rule from OMB review. While the scope of the changes HHS intends to make is unclear (the final rule was not published before the retraction), it appears that the Final Rule may include even stricter breach notification guidelines.

“This is a complex issue and the Administration is committed to ensuring that individuals health information is secured to the extent possible to avoid unauthorized uses and discloses, and that individuals are appropriately notified when incidents do occur,” the OCR announcement stated.

Health care providers should take note that the interim final rule, which took effect September of 2009, remains in effect while the details of the final rule are being developed.

The decision to pull the final rule from OBM review follows last week’s announcement that Rite-Aid Corporation and its 40 affiliated entities will pay $1 million to settle potential privacy disclosure allegations with HHS. The allegations arose after pharmacy videotapes surfaced showing that Rite Aid pharmacies disposed of prescriptions and bottle labels containing PHI in industrial trash containers that were accessible to the public.