On Friday, June 3, the American Medical Association (“AMA”) submitted its comments concerning the Accountable Care Organizations (“ACOs”) Proposed Rule (the “Proposed Rule”) to Donald Berwick, the Centers for Medicare and Medicaid Services (“CMS”) Administrator. The Proposed Rule was issued by CMS on March 31, 2011. In its comments, AMA…
On May 20, 2011, Ohio governor, John Kasich, signed Ohio House Bill 93 into law. The bill represents an effort by Ohio to strengthen the State’s regulatory framework relating to the prevention of prescription drug abuse. According to the Ohio Department of Health, since 2007, unintentional drug overdoses in the…
The national health care reform, the implementation of which effectively requires a shift of health insurer spending more heavily towards medical care, is projected to reduce insurance profit margins to approximately 3% to 5%. This is a substantial decline considering these margins historically averaged around 7% to 8%. As a…
A Florida radiology clinic, Midtown Imaging LLC, and its former owners–Midtown Imaging PA and PBC Medical Imaging–have agreed to pay $3 million to settle allegations that Midtown Imaging LLC submitted false claims to Medicare between 2000 and 2008. The allegations arose from Midtown Imaging LLC’s lease and professional services agreements…
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…
June 7, 2011, the Departments of Justice and Health and Human Services (“HHS”) announced that Reynel Betancourt, a 51 year-old Miami resident, was sentenced for his involvement in a $9 million Medicare fraud scheme originating in metro Detroit. His penalty includes 77 months in prison and three years of supervised…
The Health Law Partners, P.C. (“The HLP”) is pleased to announce that founding partner Adrienne Dresevic was recently appointed to serve as Chair, ABA Health eSource; Vice Chair, Publication Committee; Vice Chair, Stark Toolkit Editorial Board; and Judge, Law Student Writing Competition. The appointment is for the 2011 – 2012…
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…
The patient-centered medical home (“PCMH”) concept, in which a primary care physician and an interdisciplinary team coordinate the provision of patient services, continues to gain support. In April, New York State Health Commissioner Nirav Shah, M.D. promoted the state’s new initiative to increase access to PCMHs during his National Public…
On May 31, 2011, the Department of Health and Human Services (“HHS”) issued a notice of proposed rulemaking (“Proposed Rule”) in relation to the Health Insurance Portability and Accountability Act (“HIPAA”) Privacy Rule (“Privacy Rule”). The Proposed Rule concerns changes to the accounting disclosures requirement of the Privacy Rule. The…