When negotiating physician compensation issues, hospitals frequently rely upon the premise they must pay fair market value compensation in order to comply with the provisions of the Stark Act prohibiting referrals in exchange...more
There is almost universal agreement regarding predictions for 2022 federal enforcement in the following areas:
..The use of fraudulently obtained COVID relief funds in both healthcare and in general, but specifically as...more
1/20/2022
/ Audits ,
Centers for Medicare & Medicaid Services (CMS) ,
Compliance ,
Coronavirus/COVID-19 ,
Corporate Misconduct ,
Department of Justice (DOJ) ,
Enforcement ,
False Claims Act (FCA) ,
Fraud and Abuse ,
Health Care Providers ,
Personal Liability ,
Physicians ,
Relief Measures ,
Yates Memorandum
Emanuele v. Medicor Associates, was presented to the United States District Court for the Western District of Pennsylvania as cross motions for summary judgment, and provides some guidance regarding the Stark requirements for...more
CMS has issued the final regulations to implement that section of the Affordable Care Act amending the Social Security Act to provide that retention of identified overpayment could be a false claim and be subject to both the...more
Cooper v. Pottstown Hospital is another case where a dissatisfied party is attempting to use the federal Anti-Kickback Statute or the Stark Law in litigation arising out of the contracts to which they were willing parties at...more
In United States ex rel. Martin et al. v. Life Care Centers of American, Inc., the Court held that the government could extrapolate from a random sample in order to impose False Claims Act (FCA) liability against Life Care...more