Melissa Brown

Melissa Brown

BakerHostetler

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Collateral Damage: Medicaid Inspector General Says You're Fired!

The New York Court of Appeals recently ruled that the Office of the Medicaid Inspector General (OMIG) has discretion to exclude a physician from New York's medical assistance program (Medicaid) based solely on a consent order...more

11/6/2013 - Inspector General Medicaid Physicians Termination

Pay to Play Quickly — CMS's New Slow Motion Surveys for Acquirers Rejecting Assumption of Medicare Agreements

The Center for Medicare and Medicaid Services (CMS) recently issued a policy memorandum to state survey agency (SSA) directors regarding the effect of rejecting a Medicare agreement in connection with the acquisition of a...more

9/23/2013 - Affordable Care Act CMS Healthcare Reform Medicare Pay or Play

Physicians Are My Friends; Surely I Can Get Paid to Talk to Them!

On April 26, 2013, the U. S. Department of Justice (DOJ) intervened in a whistleblower case alleging Novartis Pharmaceuticals Corporation (Novartis) knowingly and willfully violated the federal FCA by inducing physicians to...more

6/19/2013 - Corporate Integrity Agreement DOJ False Claims Act Kickbacks Novartis Prescription Drugs Whistleblowers

Novel “Bad Faith Admission” EMTALA Theory Survives Motion to Dismiss

The U.S. District Court for the Northern District of California recently denied Contra Costa Regional Medical Center’s (CCRMC) motion to dismiss regarding an alleged violation of the Emergency Medical Treatment and Labor Act...more

5/3/2013 - EMTALA Liability Motion to Dismiss

Too Big to Exclude; Too Much Wrongdoing to Ignore

A 2007 audit initiated by a Medicare Program Safeguard Contractor (PSC) discovered that a North Carolina provider had a high incidence of inpatient billings for patients who did not stay in the hospital overnight. The PSC's...more

2/26/2013 - CMS Deferred Prosecution Agreements False Statements Medicare WakeMed

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