Norman Tabler, Jr.

Norman Tabler, Jr.

Faegre Baker Daniels

Contact  |  View Bio  |  RSS

Latest Publications

Share:

Hospitals and Health Insurers Prodded on Same-Sex and Transgender Issues

In separate actions yesterday, CMS and the New York State insurance regulatory authority took steps to (a) assure equal treatment of same-sex spouses by hospitals and (b) insurance coverage of medically necessary transgender...more

12/15/2014 - CMS Health Insurance Hospitals Insurers Same-Sex Marriage Transgender

Government Applauds Gainsharing, But It's Still Illegal

It's frustrating enough when the government opposes a good idea and makes it illegal. But "gainsharing" presents an even more frustrating situation for hospitals. Why? Because the government continually signals its agreement...more

12/12/2014 - CMS Gainsharing Hospitals Medicare

AHA Proposes Putting RACs on the Rack

The American Hospital Association formally proposed last week that Recovery Audit Contractors (RACs) be fined when their denials are overturned on appeal....more

12/11/2014 - Administrative Appeals American Hospital Association Hospitals RACs

Supreme Court Rejects Whistleblower’s Double-Dip Attempt

On Monday the United States Supreme Court declined to hear Danny Smart’s appeal of the Fifth Circuit’s rejection of his attempt to share in the proceeds of a $5 million settlement of a False Claims Act suit brought by another...more

12/10/2014 - Christus Health Commercial Leases False Billing False Claims Act Hospitals Physicians Popular SCOTUS Whistleblower Awards Whistleblowers

It’s Risky to Bill Over 24 Hours in a Day

Remember the old joke about the lawyer standing at the pearly gates? He says he’s 52. St. Peter answers, “That’s strange. According to your time records, you’re 89.”...more

12/1/2014 - Criminal Prosecution Healthcare Fraud

GAO Takes Aim at GPOs

The GAO had drawn a bead on GPOs. In a report issued yesterday the Government Accountability Office expressed concern over the effect of GPOs (group purchasing organizations) on Medicare rates. The report recommended that...more

11/26/2014 - GAO GPOs HHS Hospitals Medicare

Growing Safety Risk for Hospitals: Spiraling Medical Device Recalls

Everyone knows that the number of medical device recalls is on the rise. Here are two telling examples of the growth. In 2003 a total of 604 recalls were reported to the FDA, while last August a single manufacturer recalled...more

11/25/2014 - FDA Healthcare Hospitals Medical Devices Product Recalls

Orthopedic Patient Doesn’t Have a Leg to Stand On

It’s well known that Medicare, Medicaid and commercial insurers hate the ever-increasing trend of hospitals buying facilities and practices and then charging provider-based (i.e., higher) rates than the facilities and...more

11/21/2014 - Ambulatory Surgery Centers Healthcare Healthcare Fraud Hospitals Medicare

CFO’s Thirst for Wine Club Invitation Costs Hospital Millions

You can’t make this stuff up. Last Monday a federal court in Rhode Island ordered two insurance companies to pay a $30 million claim by hospital management company Lifespan Corp. Lifespan filed the claim after being ordered...more

11/20/2014 - CFOs D&O Insurance Fiduciary Duty Hospitals Insurers Interest Rate Swaps Management Companies

Where All the Hospitals Are Above Average

According to the report, 1,224 hospitals are “top performers.” The report was released in Chicago – not Lake Wobegon – but the number of top performers represents about 37% of all hospitals in the sample, which consists of...more

11/18/2014 - Healthcare hosp Ratings

Seventh Circuit: No Fraud in Billing Medicaid More than Private Insurers for Drugs

Last Wednesday the Seventh Circuit affirmed the dismissal of a whistleblower suit brought by a pharmacist against his former employer, the Shopko pharmacy chain, for what he alleged was fraudulent billing of Medicaid by...more

11/17/2014 - Dismissals False Claims Act Fraud Medicaid Pharmacies Retailers Whistleblowers

November Generality-in-Pleading Award

We’re only one-third of the way through the month of November, but we already have a winner of November’s Generality-in-Pleading Award. The hands-down winner is Dr. Warren Troxler, whose False Claims Act whistleblower suit...more

11/12/2014 - False Claims Act Pleadings Whistleblowers

HIPAA Isn’t the Only Standard for Confidentiality

Nobody knows better than hospitals how difficult, complicated and expensive it is to comply with the confidentiality requirements of HIPAA (for Health Insurance Portability & Accountability Act). And hospitals and their...more

11/7/2014 - HIPAA Hospitals Patient Confidentiality Breaches

CME Payments Exposed to Sunshine, But Not Too Much

Sometimes there’s less to life than meets the eye. Take the final rule issued last Friday by CMS on reporting CME (for continuing medical education) payments under the Physician Payments Sunshine Act....more

11/6/2014 - CME CMS Healthcare Healthcare Reform Sunshine Act

Another Halloween Treat: the OIG’s 2015 Work Plan

On Halloween the Office of Inspector General (OIG) of Health & Human Services released its “Work Plan Fiscal 2015.” The 90-page document is meant to tell the public, and especially health care providers paid by Medicare and...more

11/5/2014 - Healthcare Hospitals Medicaid Medicare OIG Work Plans

Halloween Announcement of CMS Payment Changes

Maybe it was a coincidence, but CMS waited until Halloween to announce its final 2015 payment policies for physicians and hospital outpatient departments. While the announced changes are not really scary, one evoked sharp...more

11/4/2014 - AMA CMS Health Care Providers Hospitals Physician Payments Physicians Provider Payments

Texas Hospital Qualifies for Exception to Limitation on Exception to Elimination of Exception to Stark Law

Lake Pointe Medical Center has become the first hospital in America to qualify for (i) an exception to (ii) the limitation on the (iii) grandfather exception to the (iv) elimination of the (v) whole-hospital exception to the...more

11/3/2014 - CMS Exceptions Hospitals Stark Law

One Last Shot at Meeting October Deadline on Two-Midnight Appeals

On October 27, 2014, the Centers for Medicare & Medicaid Services (CMS) made a concession—a very small one—to hospitals racing against the looming October 31, 2014, deadline for accepting the offer of 68 cents on the dollar...more

10/31/2014 - Appeals CMS Deadlines Healthcare Two-Midnight Rule

Goliath Defeats David in Ohio Hospital Suit

On Monday the court unsealed its October 20 decision handing Premier summary judgment. Tiny Medical Center at Elizabeth Park (MCEP) had sued the Premier hospitals, alleging they had engaged in an antitrust conspiracy to keep...more

10/30/2014 - Antitrust Conspiracies Antitrust Litigation Healthcare Hospitals

U.S. Accuses NYC of Massive Fraud in Program for Developmentally Challenged Toddlers

It’s the city that never sleeps. So when it does something, it can do it in a big way. That applies to Medicaid fraud, according to a suit filed yesterday by the U.S. Attorney for the Southern District of New York....more

10/29/2014 - Fraud Healthcare Healthcare Fraud Medicaid

Counting on Hospice Care? Try to Hang on Until 2017

Yesterday’s Washington Post “Business of Dying” article is a sobering account of how little information is available on the quality—or lack of quality—of hospice organizations. Almost no information on quality is available...more

10/28/2014 - Affordable Care Act CMS Healthcare Hospice

Good News for Guilty Whistleblowers!

Want to be a whistleblower but worried your own wrongdoing will prevent it? If so, Tuesday’s decision by a federal court in Texas should come as welcome news. In that long-running False Claims Act case, the court rejected a...more

10/24/2014 - False Claims Act Omnicare Prior Wrongful Acts Whistleblowers

Hospital Conversion to For-Profit Status Improves Health (i.e., Financial Health)

For years the debate has raged: Does conversion of a nonprofit hospital to for-profit status result in a decline in clinical quality? An improvement? More efficient operations? A decrease in the volume of indigent and...more

10/23/2014 - Healthcare Hospitals Information Reports Non-Profits Quality of Care Standards

Third Circuit Tightens “Original Source” Requirement for Whistleblowers

Back in 2003 Karl Schumann filed a whistleblower suit alleging that as an executive with benefits company Medco, he learned that Bristol-Myers Squibb and AstraZeneca paid kickbacks to Medco to buy and recommend brand name...more

10/22/2014 - Compliance Evidence False Claims Act Whistleblowers

Seventh Circuit Reaffirms Worthlessness of Worthless Services Cases

In August the Seventh Circuit expressed its view that so-called “worthless services” cases don’t state a claim under the False Claims Act. Last Friday the court reaffirmed its view by refusing to rehear the case en banc....more

10/21/2014 - False Claims Act Healthcare Medicaid Medicare Nursing Homes Worthless Services Claims

97 Results
|
View per page
Page: of 4