Michael Joseph

Michael Joseph

McAfee & Taft

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Latest Publications


CMS Audit Practices: How false can you get?

Caring Hearts Personal Home Care Services provided physical therapy and skilled nursing services to homebound Medicare patients. During an audit, CMS determined that Caring Hearts provided services to patients who didn’t...more

8/15/2016 - Administrative Proceedings Appeals Audits CMS False Claims Act (FCA) Health Care Providers Healthcare Fraud Medicare Physical Therapists Retroactive Application Reversal Skilled Nursing Facility

Technology and the Future of Cities: Oklahoma City's Innovation District: The new knowledge hub

Civic and community leaders in Oklahoma City are developing an Innovation District. An Innovation District is a development based on the premise that economic growth, job creation, and innovation can be fostered through the...more

3/9/2016 - Infrastructure Innovation Special Districts State and Local Government Technology Urban Planning & Development

Stark: A Stagnant Law For An Evolving Industry

The Stark Law was originally enacted by Congress in 1989 as the Ethics in Patient Referrals Act. Initially, it prohibited a physician from referring Medicare beneficiaries to clinical labs in which the physician had an...more

2/18/2016 - CMS Fair Market Value False Claims Act (FCA) Patient Referrals Stark Law

Payment is due at the time services are rendered

Typically, physicians collect co-payments from patients when services are provided, submit claims for reimbursement to government and commercial payers, and then send bills to patients for the balance owing. The payment and...more

8/3/2015 - Billing Consumer Credit Protection ECOA Finance Charges Health Insurance Interest Rates Notice Requirements Office of Consumer Affairs Patients Payment Plans Physicians Truth in Lending Act (TILA)

The skinny on narrow networks

The insurance exchanges created under Affordable Care Act have facilitated increased competition. Old version managed care models implemented cost-savings measures like pre-authorizations for medical care, hospital length of...more

6/24/2015 - Affordable Care Act Benefit Plan Sponsors Employer Group Health Plans ERISA Health Care Providers Health Insurance Health Insurance Exchanges Healthcare Skinny Plan

Physicians as whistleblowers: Doctors get rich by exposing fraud

As the federal and state governments have evolved from Uncle Sam to Doctor Sam, the potential for healthcare waste, fraud and abuse has also increased. One way the government has deterred healthcare fraud is by enacting and...more

5/22/2015 - Affordable Care Act Anti-Retaliation Provisions DOJ False Claims Act (FCA) Healthcare Fraud Medicaid Medicare Physicians Qui Tam Whistleblowers

Innovation Districts

Last year representatives of a coalition of 11 organizations started meeting to discuss the continued development and expansion of Oklahoma City’s bioscience and technology sectors. Among other matters, the group discussed...more

3/30/2015 - Biotechnology Economic Development Innovation Life Sciences Special Districts Tax Incentives Technology Urban Planning & Development

Hospital-Physician Alignment

Hospital-physician alignment involves the effective coordination between physicians and hospitals in order to accomplish and prioritize patient care and financial goals. Those goals may relate to better patient-centered care,...more

3/3/2015 - Healthcare Hospitals Physicians

Challenges Physicians Can Expect in 2015

Reimbursement for medical services continues to decline. Continuing uncertainty about the Affordable Care Act persists. Government regulations create burdensome paperwork, busywork, and compliance headaches. Technology costs...more

1/12/2015 - Affordable Care Act Cybersecurity Health Insurance Healthcare Hospitals OIG Physicians Regulatory Standards Strategic Enforcement Plan Technology

Oklahoma Legislature significantly expands peer review privilege

Oklahoma’s peer review statute provides that peer review information is private, confidential, and privileged. It encourages health care professionals to police themselves by evaluating their peers. It also promotes the...more

12/14/2014 - Health Care Providers Healthcare Healthcare Facilities Peer Review

Norman Physician Hospital Organization — Factors Supporting Clinical Integration

Clinical integration is a somewhat imprecisely defined concept in the health care industry. Lawyers and health care executives have identified components and elements of clinical integration and frequently ask how many of...more

9/23/2013 - Clinically Integrated Networks (CINs) Competition Compliance FTC Healthcare Norman PHO Physician Hospital Organizations Physicians

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