Donna S. Clark

Donna S. Clark

BakerHostetler

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Tuomey Judgment Upheld in Novel Stark Law and False Claims Act Case

The U.S. Court of Appeals for the Fourth Circuit recently upheld the judgment against Tuomey Healthcare System, Inc. (Tuomey), in a qui tam False Claims Act case predicated on Stark Law violations. The district court in the...more

7/20/2015 - Appeals Eighth Amendment Employment Contract False Billing False Claims Act Fifth Amendment Healthcare Physician Compensation Arrangements Qui Tam Stark Law

Providers Get Rare Win in New Texas Law Protecting Out-of-Network Referrals

On June 1, 2015, Texas Governor Greg Abbott signed House Bill 574 into law protecting physicians and other providers from having their participating provider agreements terminated by an insurer solely because the provider’s...more

7/13/2015 - CHIP Covered Providers Health Insurance Healthcare Healthcare Providers Medicaid Out of Network Provider Physicians

OIG Fraud Alert Cautions Against Sham Medical Director Arrangements

The HHS OIG recently issued a brief fraud alert (Fraud Alert) reminding physicians that inappropriate compensation arrangements may lead to enforcement actions under the federal anti-kickback statute and Civil Monetary...more

6/25/2015 - Anti-Kickback Statute CMP Law Healthcare HHS Hospitals Medical Directors OIG Patient Referrals Physician Compensation Arrangements Risk Alert Stark Law

OIG Advisory Opinion Sheds Light on Preventive Care Exception

The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) recently issued an advisory opinion approving an arrangement whereby a licensed entity providing services under a state program for...more

2/17/2015 - Advisory Opinions Anti-Kickback Statute Healthcare HHS Medicaid OIG Preventive Health Care

OIG Proposed Anti-Kickback Safe Harbors and CMP Regulations: The End of Frustration or Just the Beginning?

On October 3, 2014, the U.S. Department of Health and Human Services Office of Inspector General (OIG) published an unexpected, yet long-awaited, set of proposed rules that would add new anti-kickback law safe harbors,...more

10/17/2014 - Affordable Care Act Ambulance Providers Anti-Kickback Statute CMP Law Gainsharing Healthcare Medicaid Medicare Medicare Part D OIG Pharmacies Proposed Regulation Safe Harbors

Summer Fraud and Abuse Roundup

The federal government was busy over the summer when it came to decisions and settlements under the Stark Law, anti-kickback law and federal False Claims Act. This article revisits recent developments with respect to...more

8/25/2014 - Anti-Kickback Statute False Claims Act Fraud and Abuse Healthcare Healthcare Fraud Settlement Stark Law Whistleblowers

Stark Law Update: All Children’s Settles False Claims Act Allegations

All Children’s Health System (ACHS) will pay the federal government and state of Florida $7 million to settle allegations that it violated the federal and Florida False Claims Act statutes by submitting claims to Medicaid...more

5/7/2014 - False Claims Act Medicaid Stark Law Whistleblowers

Halifax Reportedly Settles Landmark Stark Case

According to minutes filed in the U.S. District Court for the Middle District of Florida, Halifax Hospital Medical Center (Halifax) and the U.S. Department of Justice (DOJ) have reached a settlement in the pending False...more

3/11/2014 - DOJ False Claims Act Healthcare Healthcare Professionals Hospitals Physicians Stark Law

OIG and CMS Extend Expiration Date for EHR Donations

As the final days of 2013 passed and the sunset of the Stark Law exception and anti-kickback law safe harbor for electronic health record (EHR) donations loomed nearer, the U.S. Department of Health and Human Services (HHS)...more

1/30/2014 - CMS Data Protection Deadlines EHR Healthcare OIG PHI

Federal Judge Dismisses All Anti-Kickback Claims in Halifax Hospital Medical Center Case

On January 8, 2014, the U.S. district judge in the Halifax Hospital Medical Center (Hospital) case pending in the Middle District of Florida granted the Hospital's motion to dismiss all of the relator's anti-kickback law...more

1/29/2014 - Anti-Kickback Statute False Claims Act Florida Healthcare Fraud Hospitals Kickbacks Relators Stark Law

Feds Win Crucial Motions in Two High-Stakes Stark Cases

On the heels of the landmark Tuomey case (see the October 3, 2013 issue of the Health Law Update), the federal government recently has seen success in two more False Claims Act cases predicated on alleged Stark Law...more

12/16/2013 - False Claims Act Healthcare Hospitals Physicians Stark Law

Two for Me; Many Times More for the Government in the Largest Whistleblower Award Against a Community Hospital

A U.S. district judge in South Carolina approved the government's request for a civil penalty award and ordered Tuomey Healthcare System, Inc. (Tuomey) to pay more than $237 million in damages and fines in a whistleblower...more

10/7/2013 - FCA Healthcare Professionals Hospitals Medical Liability Stark Law Whistleblowers

Hospital Ordered to Produce Privileged Documents Under the Crime-Fraud Exception

A magistrate judge in the U.S. District Court for the Middle District of Florida recently ordered a hospital defendant in a False Claims Act (FCA) case to turn over two prime documents to the U.S. Department of Justice and...more

5/31/2013 - Attorney-Client Privilege Crime-Fraud Exception DOJ False Claims Act Hospitals Whistleblowers

Groundhog Day for Tuomey: Jury Finds Hospital Violated Stark Law and False Claims Act

On May 8, 2013, a jury in the Columbia Division of the U.S. District Court for the District of South Carolina returned a verdict finding that Tuomey Healthcare Systems, Inc. (Tuomey) violated the Stark Law and the federal...more

5/22/2013 - False Claims Act Healthcare Hospitals Medicare Physicians Stark Law Whistleblowers

OIG and CMS Issue Proposals to Extend Safe Harbor and Exception for EHR Donations

In the April 10 Federal Register, two agencies within the U.S. Department of Health and Human Services published proposed rules that many healthcare providers have been anxiously awaiting affecting donations of electronic...more

4/22/2013 - Anti-Kickback Statute CMS Electronic Medical Records Healthcare Medical Devices OIG Physicians Safe Harbors Stark Law

OIG Issues Special Fraud Alert for Physician-Owned Entities

The U.S. Department of Health and Human Services Office of Inspector General (OIG) recently issued a Special Fraud Alert expressing concern that physician-owned entities "that derive revenue from selling, or arranging for the...more

4/5/2013 - Anti-Kickback Statute Fraud HHS Medical Devices Physician-Owned Distributors Physicians

OIG Advisory Opinion Sheds Light On Pay-For-Performance Relationships Between Hospitals And Physicians

On January 7, 2013, the HHS OIG released Advisory Opinion 12-22 concerning a rural hospital's (Hospital) proposal to pay a cardiology group (Group) a performance bonus for achieving certain patient service, quality and cost...more

1/20/2013 - Anti-Kickback Statute Civil Monetary Penalty HHS Hospitals Medicaid Medicare OIG Pay-for-Performance Physicians Stark Law

Health Law Update — January 10, 2013

In This Issue: - Healthcare Provisions in the American Taxpayer Relief Act - the Good, the Bad and the Ugly - American Taxpayer Relief Act Amends Overpayment Recovery Time Limits - OIG Advisory Opinion Sheds...more

1/14/2013 - American Taxpayer Relief Act CMS Data Breach Electronic Medical Records Fraud Healthcare OCR OIG Overpayment Recovery Time Limits Pay-for-Performance Reporting Requirements Settlement

A Message From Donna Clark And Darby Allen On The A To Zs Of Stark Law Compliance

Healthcare providers, particularly physicians and hospitals, regularly engage in business arrangements that may implicate the federal self-referral law, known as the Stark Law. Recent changes to the Stark Law, including...more

12/10/2012 - CMS Compliance DOJ False Claims Act HHS OIG Stark Law

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