Five U.S. senators requested an investigation by the Inspector General of the Department of Health and Human Services (“HHS”) into the legality of physician-owned distributorships (“PODs”). The legality of the PODs is being questioned under the federal Anti-kickback Statute and other fraud and abuse laws. Distributorships act as a link between medical device manufacturers and […]
In February, the Centers for Medicare and Medicaid Services (“CMS”) settled the first Stark matter since the publication of the CMS Voluntary Self-Referral Disclosure Protocol (“SRDP”). Although CMS spokesperson, Ellen Griffith, would not provide additional details, she confirmed that a settlement was reached. According to other sources, however, the first Stark case involved Saints Medical […]
In the Office of Inspector General’s (OIG) Advisory Opinion 11-02, the OIG examined a proposed arrangement in which the Requestor–a non-profit, tax-exempt corporation that operates an outpatient acute care hospital–would provide complimentary transportation services to patients and their families at physicians’ offices located on, or contiguous to, the Requestor’s campus (Physicians) to the Requestor’s acute […]
Over $225 million in false billing, 111 defendants, and 9 cities across the country. The Medicare Fraud Strike Force charged doctors, nurses, physical and occupational therapists, healthcare company owners and executives and others in the largest Medicare fraud takedown ever. The defendants are accused of various healthcare fraud-related crimes, including conspiracy to defraud Medicare, criminal […]
The 38-count indictment charged 20 individuals with various healthcare fraud, kickback and money laundering charges related to their alleged participation in a healthcare fraud scheme involving approximately $200 million in Medicare billing for mental health services. The defendants worked with and for American Therapeutic Corporation (ATC) and Medlink Professional Management Group Inc. allegedly submitting false […]
The FY 2010 Health Care Fraud and Abuse Control Program Report was issued on January 24, 2011 by the Office of Inspector General (“OIG”). This report summarizes the health care fraud prevention and enforcement efforts that yielded results during fiscal year (“FY”) 2010. According to the Report, the federal government recovered more than $4 billion […]
On December 28,2010, the Office of Inspector General (“OIG”) published Advisory Opinion 10-26, wherein the OIG concluded that an ambulance provider offering discounted rates to skilled nursing facilities (“SNFs”) could violate the Anti-Kickback Statute (“AKS”). In Advisory Opinion 10-26, Requestor is a nonprofit Medicare and Medicaid certified ambulance supplier providing emergency and non-emergency transportation services, […]
When advising clients regarding the legal risks potentially implicated by the health care transactions into which they contemplate entering, we at The Health Law Partners have consistently articulated the mantra that “there is substantially heightened scrutiny in the regulatory arena.” It is not uncommon for clients to inquire, upon hearing this, whether the risks are […]
$2.5 billion in settlements in crackdown against fraud. The federal government has announced the largest settlement amounts in the history of the False Claims Act for fiscal 2010. The $2.5 billion amount received from healthcare False Claims Act cases remarkably does not include hundreds of millions of dollars that the Justice Department has secured from […]
Effective January 1, 2011, the new Stark In-Office Ancillary Services Exception (the “IOASE”) provisions will require physicians or group practices relying upon the IOASE (collectively, “Physician Practices”) to furnish the following notice/disclosure to patients receiving MRI, CT, and PET (as identified on the Stark CPT/HCPCS Code list): • Written notice at the time of the […]
Health Law Attorney Blog