New Reporting Requirements Under CTA

Effective January 1, 2024, the Corporate Transparency Act (“CTA”) requires most businesses, including healthcare businesses, to report certain information regarding beneficial owners and company applicants. Willful failure to report or update beneficial ownership information may result in the imposition of penalties.

CTA in a Nutshell

The CTA and its implementing regulations seek to prevent and combat money laundering, terrorist financing, corruption, tax fraud, and other illicit activities. To prevent the use of shell and front companies to obfuscate the identities of illicit actors, the implementing regulations require reporting companies to report certain information on beneficial owners (“BOI”) and, for companies formed after January 1, 2024, company applicants. Unless an exception applies, the reporting requirement applies to domestic and foreign entities.

This information is reported to the Financial Crimes Enforcement Network (FinCEn) of the U.S. Department of Treasury.

FinCen recently clarified that the CTA requirement to provide BOI is separate and distinct from the requirement for businesses to report BOI to financial institutions.

Beneficial Owner And Company Applicant

A “beneficial owner” is defined as someone who: (a) exercises substantial control over a reporting company; or (b) owns or controls at least 25 percent of the ownership interests of a reporting company. A “reporting company” is a domestic or foreign entity required to report the beneficial ownership information.

Reporting companies are required to identify all individuals who exercise substantial control over the company. There is no limit to the number of individuals who can be reported for exercising substantial control.

An individual who exercises “substantial control” over a reporting company is defined as someone who meets any of the four general criteria: (1) the individual is a senior officer; (2) the individual has authority to appoint or remove certain officers or a majority of directors of the reporting company; (3) an important decision-maker; or (4) the individual who has any other form of substantial control over the reporting company.

Additionally, reporting companies are required to identify all individuals who “own or control at least 25 percent of the ownership interests” of the company. Any of the following may be an ownership interest: equity, stock, or voting rights; a capital or profit interest; convertible instruments; options or other non-binding privileges to buy or sell any of the foregoing; and any other instrument, contract, or other mechanism used to establish ownership.

Furthermore, reporting companies formed on or after January 1, 2024, would need to provide information on the company applicant. A “company applicant” is defined the individual who files the document that creates the entity in the United States, or, in the case of a foreign reporting company, an individual who files the document that first registers the entity. The regulations additionally specify that anyone who directs or controls the filing of an entity creation or registration document by another would also be a company applicant and would need to be reported to FinCen.

The beneficial owner information reported to FinCen is not publicly available. In certain circumstances, FinCen is authorized to share BOI with government agencies, financial institutions, and financial regulators.

Reporting Timeline

The reporting timeline depend on when the reporting company was created or registered; and whether the report is an initial report, an updated report providing new information, or a report correcting erroneous information in a previously filed report. In sum:

  • A reporting company created or registered to do business before January 1, 2024, will have until January 1, 2025, to file its initial beneficial owner report (“BOI”) report.
  • A reporting company created or registered in 2024 will have 90 calendar days to file after receiving actual or public notice that its creation or registration is effective.
  • A reporting company created or registered on or after January 1, 2025, will have 30 calendar days to file after receiving actual or public notice that its creation or registration is effective.

Reporting Requirements

The following information needs to be reported for each beneficial owner and company applicant:

  • the individual’s full legal name;
  • date of birth;
  • current residential or business street address; and
  • a unique identifying number from an acceptable identification document (e.g., a passport)—or the individual’s FinCEN identifier.

Twenty-three specific types of entities are exempt from the reporting requirement.

If there is any change to the required information about a company or its beneficial owners in a BOI, an updated report must be filed no later than 30 days after the date of the change.

If you have questions about the new CTA reporting requirements please contact our office.

The End of Non-Competition Agreements?

Recently, the Federal Trade Commission (“FTC”) published a proposed rule prohibiting employers from using non-compete clauses (also called “restrictive covenants”) in their contracts with workers. Similarly, the New Jersey legislature recently proposed a bill that would limit the scope of restrictive covenants between employers and workers. If finalized, these measures would impact the relationship many physicians, nurses and other healthcare professionals have with their employers.

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Significant Changes to NYS Mandatory Compliance Program Requirement

Last year, as part of the 2020-2021 budget, the New York State Legislature made significant changes to the NYS Mandatory Compliance Program requirement. Providers required to adopt and implement an effective compliance program should be aware of the changes to avoid the imposition of penalties or other sanctions.

While dealing with the fall-out of the Pandemic in 2020, many providers may not have noticed that effective April 1, 2020, the Social Service Law 363-d underwent significant changes.

The first significant change was the specification that meeting the requirements of New York Social Services Law (“SSL”) § 363-d is now a “condition of payment from the medical assistance program,” for those providers mandated to adopt and implement an effective compliance program. This legislative change now provides the Medicaid Inspector General (“OMIG”) with the direct authority to recoup Medicaid payments made to a provider during a period when OMIG determines that a provider was non-compliant with the compliance program requirement.

In addition to recoupment, the amended law now gives OMIG the power to impose penalties on those providers that fail to adopt and implement an effective compliance program. OMIG may impose a penalty of $5,000.00 per month for up to twelve months. If OMIG imposed penalties on a provider for failing to adopt and implement an effective compliance program within the past five years, then OMIG is authorized to impose penalties of $10,000.00 per month for up to twelve months.

The third significant amendment entails OMIG’s authority to impose penalties on a provider for failing to report and return an overpayment within 60 days after the date on which the overpayment was identified (or the date a cost report is due, if applicable). The language of the amended statute gives OMIG broad powers to sanction a provider if the agency determines that a provider should have, but did not, exercise reasonable diligence to identify an overpayment. Specifically, it states that “[a] person has identified an overpayment when the person has or should have through the exercise of reasonable diligence, determined that the person has received an overpayment and quantified the amount of the overpayment.” (emphasis added). Furthermore, “[a] person should have determined that the person received an overpayment and quantified the amount of the overpayment if the person fails to exercise reasonable diligence and the person in fact received an overpayment.”

In furtherance of the requirement to report and return an overpayment within 60 days, the law now has adopted a formal self-disclosure program which mainly tracks the self-disclosure protocol that OMIG has already implemented prior to the legislative amendment.

Other changes include a requirement that compliance programs not only prevent waste, fraud and abuse but also prevent, detect and correct non-compliance with NYS Medicaid requirements.

Separately from the legislative action, OMIG made changes to the annual December certification requirement for providers. Specifically, providers no longer need to complete the annual “SSL Certification,” on OMIG’s website. Instead, a provider adopting and maintaining an effective compliance program will now record (attest to) this as part of their annual “Certification Statement for Provider Billing Medicaid.” This annual certification occurs on the anniversary date of the provider’s enrollment in Medicaid.

If you have questions regarding the new compliance program requirement under New York Social Services Law (“SSL”) § 363-d and the implementing regulations at 18 NYCRR Part 521, the annual provider certification requirement, or have other health law related questions, please contact our office.

New OPMC Requirements

On October 7, 2020, New York State Public Health Law 230 was amended to require every physician’s “practice setting” to post a conspicuous sign regarding where to report professional misconduct.

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NYS Medicaid Implements 1% Across the Board Payment Reduction

Beginning with dates of services of January 1, 2020, all non-exempt New York State Medicaid payments to providers will be uniformly reduced by 1%.

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10 Advertising Rules New Jersey’s Opticians Should Remember

Similar to other licensed healthcare professionals, New Jersey’s ophthalmic dispensers and ophthalmic technicians have to follow certain rules and regulations when it comes to adverting their practice. New Jersey’s State Board of Examiners of Ophthalmic Dispensers and Ophthalmic Technicians (“Board”), the state licensing and governing agency, has extensive regulations governing the do’s and don’ts of advertising for ophthalmic dispensers and technicians. Below we summarize a subset of those rules.

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HCFAC 2018 Annual Report Highlights Thousands of Provider Exclusions and $2.3 Billion in Recoveries

It is the twenty-second year of the Health Care Fraud and Abuse Control Program (HCFAC) established by the Health Insurance Portability and Accountability Act of 1996. The HCFAC’s annual report for 2018 shows continued focus on preventing and eliminating fraud, waste and abuse from the Medicare and Medicaid programs and increased cooperation between government agencies to facilitate data sharing.

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DMEPOS Suppliers Beware: Pressure Reducing Support Surfaces Now Require Prior Authorization Nationwide

The Centers for Medicare & Medicaid Services (“CMS”) announced in April of this year that it is adding 12 new HCPCS codes to the Required Prior Authorization List of DMEPOS items that require prior authorization as a condition of payment. Prior authorization for Pressure Reducing Support Surfaces will be implemented nationwide in October.

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5 Ways In Which the New Law Expands New Jersey’s Medical Marijuana Program

On July 2, 2019, New Jersey’s Governor, Phil Murphy, signed into law the Jake Honig Compassionate Use Medical Cannabis Act (“Act”) (previously known as the New Jersey Compassionate Use Medical Marijuana Act) which greatly expands and reforms New Jersey’s Medical Marijuana program. Several of the legislative updates are based on the recommendations made by the New Jersey Department of Health March 2018 Report (drafted pursuant to Executive Order No. 6). Below we highlight some of the significant changes.

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Responsibilities of New Jersey’s Pharmacists In Charge

New Jersey pharmacy owners know that every New Jersey pharmacy must appoint a Pharmacist-In-Charge (“PIC”) and a pharmacy cannot operate without a PIC for longer than 30 days. Below we review some of the many responsibilities that go with the title.

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OCR Proposes Changes to the Civil Rights Enforcement Section of the Affordable Care Act Section 1557

The Department of Health and Human Services (“HHS”) and the Office of the Civil Rights (“OCR”) recently proposed changes to Section 1557 of the Affordable Care Act (“Act”). This Section of the Act prohibits civil rights discrimination in certain health programs or activities. Some of the major changes, include, among others, revising the regulatory definition of what constitutes discrimination on the “basis of sex”. The proposal also includes healthcare conscience protections. Additionally, the proposed rule would eliminate taglines and notices requirement and it would revise the language access and grievance procedures of the rule.

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Electronic Medical Records Company Settles with OCR for HIPAA Violation

An electronic medical records company recently settled with the Office of the Civil Rights (“OCR”) for violating the Health Insurance Portability and Accountability Act (“HIPAA”) following a discovery of a cyberattack on its servers which contained the protected health information (PHI) of approximately 3.5 million individuals.

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Recommendations from DOH Biannual Medical Marijuana Report

The New Jersey Department of Health’s recent biannual report recommended ways to improve the New Jersey’s Medical Marijuana Program in three key areas.

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What Is OIG’s Risk Spectrum

The Office of the Inspector General (“OIG”) recently published the False Claims Act settlements risk spectrum for the first quarter of 2019. The risk spectrum identifies the number of settled cases and their assigned risk category.

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Physicians and Dentists – Know the Hidden Costs of Your Technology/Marketing Contracts

Many website design and development contracts as well as marketing and electronic medical records agreements (“technology contracts”) contain onerous terms and layers of user fees. If a physician or a dentist (“provider”) decides to part ways with the vendor under a technology contract the transition may be costly or cost prohibitive. One of the best ways providers can protect themselves against a slue of additional costs and concerns about possible loss of data is to have the contract reviewed by a healthcare attorney before signing on the dotted line.

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OIG Looks to Remove a Safe Harbor for Certain Drug Rebates; Proposes Two New Ones

In a newly proposed rule the Office of the Inspector General (“OIG”) is proposing to exclude from the discount safe harbor certain types of remuneration offered by drug manufacturers to Part D plan sponsors and Medicaid MCOs that may pose a risk to the Federal health care programs and beneficiaries. The OIG is also proposing to add two new safe harbors. The first would protect certain manufacturer point-of-sale reductions, and the second would protect certain fixed service fees that manufactures pay to pharmacy benefits managers for services rendered to the manufacturer that meet specific criteria.

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Recent Expansion of Scope of Practice for Dental Hygienist in New Jersey

The New Jersey Board of Dentistry (Board) recently expanded the scope of practice of licensed dental hygienists, limited registered dental assistants in orthodontics and registered dental assistants. Effected providers should become familiar with these expanded parameters. 

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Expanding Role of Pharmacists and Certified Medical Assistants in New Jersey

The New Jersey Board of Pharmacy and the New Jersey Board of Medical Examiners recently adopted new regulations and amended existing ones that effect the way providers practice. The changes concern pediatric immunizations performed by pharmacists and the administration of subcutaneous and intramuscular injections and venipunctures by certified medical assistants. We briefly summarize these recent changes below. 

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CMS Proposes Sweeping Changes to E/M Service Codes and Telemedicine

The Centers for Medicare & Medicaid Services (CMS) recently published a proposed rule that, if codified, would bring about sweepings revisions to many Medicare payment policies under the physician fee schedule. Among many other changes CMS is proposing to simplify the documentation requirement for evaluation and management (E/M) code levels 2 through 5 but also proposes a flat fee for those levels of services. These and certain other proposed policy changes are briefly summarized below. 

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New York Dentists Face New Dental Anesthesia Requirements

New sweeping regulations went into effect on July 1, 2017 for dental anesthesia services in New York. The regulations, among other things, would require dentists to meet specific practice requirements, maintain more exacting records than previously required and complete additional and specific continued education courses. The regulations will also impose more stringent requirements on dentists providing dental sedation to patients 12 years old and younger. Below is a brief summary of the new requirements. 

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