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Cloudy Skies Ahead for Providers? CMS’ Release of Medicare Billing Data Combined with Physician Payment Sunshine Act Data May...

In February 2013, we reported (on our Healthcare Law Blog) that the Centers for Medicare and Medicaid Services (CMS) announced the final rule for the Physician Payments Sunshine Act. In the interest of providing more...more

6/5/2014 - CMS Drug Manufacturers Final Rules Healthcare Medicaid Medical Devices Medicare Pharmaceutical Physician Payments Physicians Reporting Requirements Sunshine Act Transparency

Potential Risks of Healthcare Joint Ventures Between Insurance Companies and Hospitals

Healthcare joint ventures are nothing new. Since the mid-2000’s, physician-hospital ventures have been resurgent, notwithstanding the Office of Inspector General’s skepticism regarding the risk of fraud and abuse when...more

5/22/2014 - Healthcare Hospitals Insurers Joint Venture

How Are Your Physicians Compensated? Stark Law + False Claims Act = Halifax Paying $85 Million

On March 10, 2014, just days before trial, Halifax Hospital Medical Center and Halifax Staffing, Inc. (collectively “Halifax”) entered into an $85 million settlement with the U.S. Department of Justice resolving allegations...more

5/22/2014 - DOJ False Claims Act Halifax Hospital Healthcare Incentives Medicare Physician Payments Physicians Qui Tam Settlement Stark Law

Update on the Provider Self-Disclosure Protocol

Since we last reported on the Provider Self-Disclosure Protocol (“Protocol”) issued by the Department of Health and Human Services, Office of the Inspector General (“OIG”), the entire Protocol has been revamped. Rather than...more

5/6/2014 - Anti-Kickback Statute Medical Devices OIG Pharmaceutical Manufacturers Provider Self-Disclosure Protocol

Navigating the Provider Self-Disclosure Protocol

Providers can voluntarily disclose potential fraud with respect to Federal health care programs — Medicare, Medicaid, and potentially private insurers to the extent Federal or state funds are involved — by following the...more

12/29/2012 - Disclosure Requirements DOJ False Claims Act Fraud HHS Medicaid Medicare OIG Provider Self-Disclosure Protocol

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