On July 30, the OIG released advisory opinion no 10-11 (the “Opinion”) which favorably reviewed a company’s proposal to encourage health care providers to use its online program for scheduling meetings with manufacturer representatives by offering the health care provider an opportunity to select a public charity to which the…
On July 23, CMS published a notice in the Federal Register, soliciting proposals in a new imaging demonstration created under the Medicare Improvements for Patients and Providers Act of 2008. The two-year Medicare Imaging Demonstration (MID) will test whether the use of decision supports systems (DSSs) can improve quality of…
The OIG for the Department of Health and Human Services entered into a Civil Monetary Penalty (CMP) settlement agreement for $7.3 million with United Shockwave Services, United Prostate Centers, and United Urology Centers (collectively, United), all of which are based in the Chicago, Illinois area. This agreement settles charges by…
CMS has released their proposed disclosure requirements for In-Office Ancillary Services (IOAS) Exception. Section 1877 of the Act or the physician self-referral law (Stark) prohibits a physician from making referrals for certain “designated health services” (DHS) payable by Medicare to an entity with which he or she has a financial…
CMS has released the proposed physician fee schedule and other Medicare Part B payment policies to ensure their payment systems reflect the changes in medical practice and relative value services. This update also addresses certain provisions of both the Affordable Care Act and Medicare Improvements for Patients and Providers Act…
The Medicare Payment Advisory Council (MEDPAC) recently delivered its 2010 report to Congress. The report entitled “Report to the Congress: Aligning Incentives in Medicare,” addressed the in-office ancillary services (IOAS) exception to the Stark Law, which allows physicians to provide most DHS services to patients in their own offices under…
By letter dated June 16, 2010, the American Society of Anesthesiologists (“ASA”) continued its efforts to request that the OIG intervene to issue a Special Advisory Bulletin prohibiting what is called the anesthesia “company model.” The ASA originally made the request to the OIG in March of 2009; however, to…
A False Claims Act lawsuit, sparked by a whistle-blower suit in 2003 filed against the Health Alliance of Greater Cincinnati and then-member Christ Hospital, has been settled, with the Health Alliance and hospital agreeing to pay the government $108 million, despite continuing to deny the allegations of the suit. The…
As reported in the May 14th HLP blog, the Departments of Justice (DOJ) and Health and Human Services (HHS) recently released the Health Care Fraud and Abuse Control Program (HCFAC) Annual Report for Fiscal Year 2009, which reflects that $2.51 billion was deposited to the Medicare Trust Fund in 2009,…
On May 6, 2010 the Office of Inspector General (the “OIG”) posted Advisory Opinion 10-04, which approved a program conducted by several imaging centers to provide free pre-authorization services to patients and referring physicians (the “Pre-Authorization Arrangement”). This approval was somewhat unexpected in light of the OIG’s prior issuance of…