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Your use of this Blog does not create an attorney-client relationship. Your e-mail or comments do not create an attorney-client relationship. We have no duty to keep confidential the information that is submitted to this blog. This blog is not a substitute for, nor does it constitute legal advice. Only an attorney who knows the details of your particular situation and is properly licensed in the applicable state (or states) is able to appropriately and properly address any legal issues you may have.

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Delivery System Reform – Will It Happen?

Although there are some big issues that remain unresolved, such as the "public plan" component, it appears that we will see reform legislation pass in 2009. Drafts of the legislation are being prepared now by various members of Congress and their staffs.

The focus on medical homes, physician hospital organizations and accountable care organizations is very real, as is the focus on payment reform, including bundled payments and other forms of capitation-like reimbursement. A key element of the debate relates to "how integrated" a provider organization will need to be to qualify for bundled payments. Can it be virtual? Can it be physician only or must a hospital be involved? What should be the role of private payors?

We wrestled with many of these questions in the 1990s, but there are new aspects now, greater data and organizational capabilities in both the purchaser and provider sectors and much more urgency to move forward with payment and delivery system reform to accompany legislation aimed at increasing access. 

One fear is that the access component will get done without payment and delivery system reform, causing costs to skyrocket and leading, potentially, to future cost controls. It is important that health care providers add their voices, individually and collectively, to this national debate. The making of major legislation is always messy, but there is real momentum right now. Whatever passes will inevitably be incomplete, and there will be unintended consequences.

Fraud Enforcement and Recovery Act of 2009 Expands FCA

On May 20, 2009 the Fraud Enforcement and Recovery Act of 2009 (“FERA”) was signed into law by President Obama. FERA expands the reach of the False Claims Act (“FCA”). The Act overrules the Allison Engine and Bombardier precedent. FERA “clarifies” that the FCA covers claims for money or property irrespective of whether the claim was “presented” to a federal employee or official, whether the federal government actually had custody of the money or property or made payments, whether the submitter specifically intended to defraud the federal government, and whether the claim was submitted to the government directly or [...]

File Identification Tool — Good Product for Identifying Encrypted Files.

I recently identified an excellent product for identifying encrypted files (and other attributes of said files). Forensic Innovations’ File Identification Technology tool identifies 3,312 File Types. Recently the product announce support for identifying “TrueCrypt”. (See www.TrueCrypt.org, they claim that “no TrueCrypt volume can be identified (volumes cannot be distinguished from random data). Computer Forensics tools might see the files as unknown or unimportant [...]

An Analysis of Data Breaches by Industry and Type

Security researches using a taxonomy to classify breaches by type and by industry using the North American Industry Classification System (NAICS), found statistically significant correlations between breach types and industries. The study is available for download from their website: [...]

Credit Monitoring Services May Not Be Required But Put the Plaintiff in a Difficult Position When Trying to Prove Damages

A number of Plaintiffs have brought actions following notification that their sensitive financial information had been disclosed during a security incident. Approximately 45 states including the District of Columbia now require that a party be informed when his/her sensitive information has been released, however, this exposure of someone’s identity even when coupled with the cost to guard against identity theft, generally does not constitute a compensable injury to state a claim for negligence or for breach of [...]

FTC Grants “Three-Month Delay of Enforcement of ‘Red Flags Rule’ Requiring Creditors and Financial Institutions to Adopt Identity Theft Prevention Programs”

The FTC announced today that the enforcement date for the Red Flag Rules is being extended until August 1, 2009 (instead of May 1, 2009). The press release is at http://www.ftc.gov/opa/2009/04/redflagsrule.shtm.
April 30th, 2009 — “The Federal Trade Commission will delay enforcement of the new “Red Flags Rule” until August 1, 2009, to give creditors and financial institutions more time to develop and implement written identity theft prevention programs. For entities that have a low risk of identity theft, such as businesses that know their customers personally, the Commission will soon release a template to help them comply with the [...]

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