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We have extensive experience with the following areas: Petroleum, Litigation, Real Estate and more.

We advise business in the following areas: Employee Benefits, Litigation, Business Advisory and more.

For those seeking counsel in real estate matters, our areas of expertise include: Construction, Development, Land Use, Litigation and more.

We handle many private matters for individuals, including: Adoption, Custody, Divorce, Domestic Partnership, Estate Planning and more.

Every criminal case is a serious matter. There are lifelong consequences for any person accused or convicted of committing a crime.

Since 1976, our litigators have effectively and efficiently represented clients in federal and state courts in business litigation, municipal law, employment law, personal injury and a variety of complex litigation.

Since 1976, our litigators have effectively and efficiently represented clients in federal and state courts in business litigation, municipal law, employment law, personal injury and a variety of complex litigation.

Since 1976, our litigators have effectively and efficiently represented clients in federal and state courts in business litigation, municipal law, employment law, personal injury and a variety of complex litigation.

As a part of the "American Recovery and Reinvestment Act of 2009" a civil penalty structure was put in place for Health Insurace Portability and Asccountability Act (HIPAA) violations.

Our experience uniquely qualifies us to advise in governmental issues: Annexation, Associations/Non-Profits, Cities, Towns, & Counties, Colleges & Universities, Economic Development, Elections and more.

We provide legal advice for businesses in the following areas: Agribusiness Energy, Diversified Businesses, Emerging Businesses, Federal & State Tax, Finance, and more.

Probate is the court procedure by which a decedent’s property is administered for the purpose of passing ownership of assets remaining in the decedent’s name at his/her death.

Since 1976, our litigators have effectively and efficiently represented clients in federal and state courts in business litigation, municipal law, employment law, personal injury and a variety of complex litigation.

Healthcare Law News - Volume 103

Somebody Had To Be First

The office for Civil Rights of HHS announced in early January its first enforcement action for lack of timely breach notification under HIPAA.  Presence Health of Illinois was the lucky winner of the first enforcement action.  Presence who operates 11 hospitals and 27 long term care and senior living facilities discovered in October 2013 that paper-based operating schedules which contained PHI of over 800 persons were missing from their facility in Joliet, Illinois.  The missing information included names, birth dates, dates and types of procedures and types of anesthesia.  Presence did not make a breach notification to HHS until January 2014 and apparently failed to notify any of the over 800 individuals of the breach, much less within 60 days of discovering the breach.  Breaches affecting more than 500 individuals require notification within 60 days of discovery and notifying prominent media outlets.  Apparently not only did Presence fail to follow the HIPAA breach notification rule, they also did not have policies and procedures in place to respond to the breach.  Presence Health agreed to pay $475,000.00 to HHS and to implement a corrective action plan to address their policy and procedure failures.

  • Do you have the proper policies and procedures in place and have you tested the policies and procedures by a simulated breach to determine if your policies and procedures will function in accordance with the breach notification rule?
  • Do you self audit your PHI security practices, your coding and billing practices and similar matters to identify weaknesses and strengths?

Once you have done these common sense things, then building a compliance policy and procedure of the type that HHS/OCR requires in their detailed regulations is much easier and much more productive and more cost effective.

Breach Damages

The purpose of awarding damages in litigation is twofold; the first is to compensate the harmed person or persons for their loss.  The second is to make sure the person causing the harm does not profit from causing that harm.  In other words, a second purpose of damages is to modify behaviors.

In numerous lawsuits, regarding large scale breaches involving companies such as Horizon Blue Cross Blue Shield of New Jersey, the companies that have allowed their customers information to be stolen, had defended lawsuits related to the breach on the basis that each individual victim of the breach is unable to prove any present harm from Horizon Blue Cross allowing an individual’s information to be stolen.  This is kind of a no harm-no fowl defense.

The victims of these breaches have argued that they should be compensated for the potential harm and for their time and effort in safe guarding and correcting information and harm from such breach.  This can include changing passwords, changing credit cards, and enrolling in credit monitoring services.  In the Horizon case, a class action data breach lawsuit, the Court dismissed the lawsuit initially on the basis that there was no proof of harm to the individuals who are the victims.  However, in a decision published in January, the Third Circuit US Court of Appeals disagreed and ordered the District Court to allow the lawsuit to proceed.  It appears that the Third Circuit was not particularly enamored of the no harm-no foul defense in any event.  The Court also found that the breach could be a violation of the Fair Credit Reporting Act.  This Act could provide for statutory damages and injunctive relief or as the basis for ordering Horizon Blue Cross to change its security practices.  The Court found that these violations placed the victims at immediate and continuing risk of harm.

Returning to why we have lawsuits and why damages are awarded, it will be interesting to see if the Fair Credit Reporting Act will be the vehicle for awarding any damages to victims and for changing behavior of companies that allow private and sensitive data to be stolen by employees or hackers.

IPC Over Billing

IPC, a physician group practice, was purchased by Team Health in 2015.  The US Justice Department accused IPC of telling its hospitalists to over bill Medicare and Medicaid.  Team Health inherited the problem when it purchased IPC.

According to the DOJ, IPC hospitalists billed for more services in a 24 hour period then could possibly have been provided.  The suit resulted from a whistleblower, Dr. Oughatiyan, who cited IPC training materials that encouraged over billing.  The result is a $60 million dollar settlement and a 5-year Corporate Integrity Agreement to “promptly detect future fraud and abuse.”


This newsletter is edited by Paul Wallace of Jones • Wallace, LLC, a member of the American Bar Association Healthcare Law Section and the American Health Lawyers Association who has been representing physicians and healthcare practices for over 25 years.  Mr. Wallace assists physicians, practices and hospitals in contract items, federal legal compliance, practice entity creation, estate and wealth planning and similar issues.  Please feel free to call if you have any questions on this newsletter or legal matters at (812) 402-1600 or pwallace@joneswallace.com.