The government does not like Physician-Owned Hospitals (“POH”). The government also does not like Physician-Owned Distributors (“POD”). The Centers for Medicare and Medicaid Services (“CMS”) and the Office of Inspector General (“OIG”) have taken several steps recently to crack down on what it views as abusive PODs and POHs. In a brand new memorandum report, […]
In June, the Office of Inspector General (“OIG”) issued two new reports on Medicare Part D titled: Ensuring the Integrity of Medicare Part D (available here) and Questionable Billing and Geographic Hotspots Point to Potential Fraud and Abuse in Medicare Part D (available here). In the Ensuring the Integrity of Medicare Part D report, the […]
On August 6, 2015, the Office of Inspector General (“OIG”) issued Advisory Opinion No. 15-12 (available here) regarding a home health provider (the “Requester”) offering free introductory visits to patients who have chosen it for home health care. The OIG concluded that this arrangement does not violate the federal Anti-Kickback Statute (“AKS”). Under the proposed […]
On July 8, 2015, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule containing major provisions relating to the Physician Self-Referral Law (i.e., the Stark Law) and its exceptions. CMS states that the purpose of the Stark proposals is: “to accommodate delivery and payment system reform, to reduce burden, and to facilitate […]
On April 20, 2015, the Department of Health and Human Services’ Office of Inspector General, in partnership with the American Health Lawyers Association and the Association of Healthcare Internal Auditors, published Practical Guidance for Health Care Governing Boards on Compliance Oversight, which describes the OIG’s expectations of the compliance oversight role healthcare governing boards (e.g., […]
June 25, 2015 On June 18, 2015, the United States Supreme Court decided the case of King, et al. v. Burwell, Secretary of Health and Human Services, et al., upholding federal subsidies for taxpayers who buy health insurance on the federal government’s healthcare.gov webpage. The potential loss of the subsidies was seen by commentators as […]
On June 18, 2015, the U.S. Department of Health and Human Services (“HHS”) arrested 243 individuals for allegedly participating in Medicare/Medicaid fraud schemes. The government claims that combined, the cases involve $712 million in supposedly false billings. As part of the sweep, the Centers for Medicare and Medicaid (“CMS”) also suspended a number of providers’ […]
In a speech at the American Bar Association’s Physician Legal Issues Conference on June 11, 2105, a representative from the Office of Inspector General (OIG) noted that the OIG is currently hiring attorneys to gear up to pursue claims against physicians under the OIG’s administrative penalty authorities. This means that the OIG will not wait […]
At the American Bar Association’s Physician Legal Issues Conference, Celeste Davis, Esq., of the Office for Civil Rights announced that, effective Monday, June 15, 2015, the Kansas City branch of the Office for Civil Rights will consolidate with the Chicago branch to form the new Department of Health and Human Services, Office for Civil Rights, […]
On June 9, 2015, the Office of Inspector General (OIG) issued a Fraud Alert titled “Physician Compensation Arrangements May Result in Significant Liability,” which is available here. In the Fraud Alert, the OIG warns physicians of the dangers of entering into compensation arrangements with health care entities, such as medical directorships or office staff arrangements, […]
Health Law Attorney Blog