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Earnout Held to Violate NY Fee Splitting Prohibition

A pivotal decision by a New York Appellate Division court holding that earnouts based on the future revenue of a dental practice violated the NY Fee Splitting Prohibition could substantially impact the structuring of health...more

DEA Permits Continuation of Telemedicine Controlled Substances Prescribing: A Temporary Pause of the Proposed Rules or a...

Earlier this year in late February, the Drug Enforcement Administration (DEA) announced proposed rules attempting to change the rules for tele-prescribing controlled drugs that were permitted during the COVID-19 Public Health...more

2016 Is Ramping Up For Telemedicine Developments

Two months in and this year has already seen significant movement in regulatory action across the country to expand the ability to provide telemedicine services. Below please find some of the more significant items that have...more

CareFirst, Third Major Health Insurer This Year To Be Hit By Cyberattack

On May 20, 2015, CareFirst BlueCross BlueShield (“CareFirst”) announced that it was the latest victim of a major cyberattack, with as many as 1.1 million plan customers affected. Current and former CareFirst members and...more

What Makes A Five Star Hospital?

The Affordable Care Act includes many provisions aimed at improving the quality of care provided by different types of health care professionals and providers. Along these lines, the ACA expands the types of facilities and...more

Lessons Learned from the Anthem Cyber-Attack and Corresponding “HIPAA Actions”

Anthem Inc. (“Anthem”), the nation's second-largest health insurer, disclosed on Wednesday, February 4, 2015, that it was the victim of a major cyber-attack. According to Anthem, the attack exposed personal information of...more

Perspectives - February 2015

In this issue: - Not-for-Profit Spotlight - Liability Exposure for Volunteers - Rules for Reimbursing Employers Up for Review—It’s a Good Time to Brush Up on the Benefits and Requirements of Your...more

Lessons Learned: May a Healthcare Professional Say No To Treating Ebola?

May a licensed healthcare professional refuse to treat a patient? Healthcare providers have legal, ethical and professional duties to address a patient’s needs that fall within the provider’s scope of practice. However, are...more

Perspectives - Trends and topics in not-for-profit management - September 2014

In this Issue: - Not-for-Profit Volunteers: HIPAA Compliance & Training - Not-for-Profit Spotlight: Project Sunshine - 10 Ways to Lose Your Not-for-Profit Status - Economic Development...more

One Of The Country’s Largest Hospital Organizations to Pay $98.15 Million Settlement on False Claims Act Allegations

On Monday, August 4, 2014, The Department of Justice announced that Community Health Systems (“CHS”) agreed to pay $98.15 million to settle nine whistleblower lawsuits alleging that the company violated the False Claims Act. ...more

One Of The Country’s Largest Hospital Organizations to Pay $98.15 Million Settlement on False Claims Act Allegations

On Monday, August 4, 2014, The Department of Justice announced that Community Health Systems (“CHS”), the nation’s largest operator of acute care hospitals, agreed to pay $98.15 million to settle nine whistleblower lawsuits...more

OIG Publishes Special Fraud Alert Regarding Laboratory Payments To Referring Physicians – Some Arrangements May Violate the...

The laboratory market has become quite competitive in recent years, raising compliance concerns and investigations into lab relationships with referring physicians. Accordingly, on June 25, 2014, the OIG released a Special...more

6/30/2014  /  Clinical Laboratories , Fraud , OIG , Physicians

The Halifax $85 Million Lesson: Compensation Arrangements Between Hospitals and Physicians Must Be Reviewed

The Department of Justice (“DOJ”) announced another multi-million dollar settlement of alleged False Claims Act violations on March 11, 2014. Specifically, Halifax Hospital Medical Center and Halifax Staffing, Inc. agreed to...more

Long Island Radiology Group Settles FCA Allegations That It Billed Medicaid And Medicare For Unnecessary Tests For $15.5M

A company operating diagnostic testing facilities in New York has agreed to pay $13.65 million to the federal government and $1.85 million to New York and New Jersey for a total of $15.5 million in penalties to settle claims...more

The UMPC – Highmark Dispute: The Beginning of the End of Medical Practices Using Hospitals’ Managed Care Contract Rates?

Recent trends across the country have health systems buying out private physician practices and reclassifying them as hospital-outpatient departments. There are a number of motivations behind these transactions, the greatest...more

OIG Releases 2014 Work Plan

The OIG recently made available its 2014 Work Plan. The Plan identifies OIG focus areas and priority projects for the coming year. This post provides a brief summary of many of the new OIG projects for fiscal year 2014 to...more

Medicare Physician Fee Schedule Expands Telehealth Coverage in 2014

The Centers for Medicare & Medicaid Services (“CMS”) recently released the final rule for Medicare’s Physician Fee Schedule for 2014 Calendar Year (“CY). While physicians are expected to see a 20.1% reduction to their...more

NYS Identifies $496 Million in Medicaid Home Health Erroneous Payments

On October 30, 2013, the New York State Office of the Medicaid Inspector General (“OMIG”) issued a press release that New York recovered $211 million from the federal government out of an identified $496 million in Medicaid...more

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