Norman Tabler, Jr.

Norman Tabler, Jr.

Faegre Baker Daniels

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Criminal Conviction Leaves Defendant Defenseless in FCA Civil Action

Pity Dr. Christina Clardy. In 2011 she was convicted of health care fraud, sentenced to 135 months in prison, and ordered to pay $16 million in restitution. Then in 2014 the government added Christina as a defendant in its...more

2/3/2016 - False Claims Act (FCA) Healthcare Fraud Medicaid Medicare

Blame Flows Downhill: All the Way to Sales Clerks

What if a store clerk sells a product that, unbeknownst to him, is illegal? Can the clerk be convicted of a crime, despite not knowing the product was illegal and not intending to sell an illegal product? On January 14,...more

2/1/2016 - FDCA Illegal Drugs Interstate Commerce Misbranding Pharmacies Strict Liability

Further CMS Clarification on EHR Hardship Exceptions

As we reported, the Centers for Medicare & Medicaid Services (CMS) posted revised instructions and application forms on January 22, 2016, for health care providers unable to meet electronic health records (EHR) “meaningful...more

2/1/2016 - CMS EHR Exemptions Meaningful Use Medicare

Was Whistleblowing a Reason for Firing or the Reason?

The outcome of a physician whistleblower’s retaliation claim against his former medical group turns on the question whether whistleblowing was a reason or the reason he was fired. If it was a reason, he loses. If it was the...more

1/27/2016 - CMS False Claims Act (FCA) Hiring & Firing Retaliation Whistleblowers

Deadline Looms for EHR Hardship Exceptions

The Centers for Medicare & Medicaid (CMS) expect 209,000 health care providers to face Medicare payment reductions for failing the electronic health records (EHR) “meaningful use” requirements in 2014. CMS puts the estimated...more

1/27/2016 - CMS EHR Health Care Providers Hospitals Medicare

Triple Damages Sufficiently Punitive to Bar Punitive Damages

Jennifer Gierer says she was fired because she expressed concerns about her employer’s submission of false durable medical equipment claims to Medicare. So she sued her employer and her boss, alleging (a) retaliation under...more

1/6/2016 - False Claims Act (FCA) Hiring & Firing Punitive Damages Treble Damages Wrongful Termination

GAO Report Says Hospital-Physician Consolidation Requires Payment Reform

Yesterday the Government Accountability Office (GAO) requested that Congress order Health & Human Services to equalize Medicare payments for the same services, whether provided in a physician office or in a hospital...more

12/24/2015 - GAO Health Care Providers HHS Hospitals Medicare

7th Cir. Won’t Let EEOC Skip Pre-Suit Conciliation

When CVS fired store manager Tonia Ramos in 2011, it offered her its standard severance agreement that included a broad release of waivable claims, including claims under Title VII, but explicitly preserving the right to...more

12/21/2015 - Age Discrimination Conciliation CVS EEOC Hiring & Firing Pattern or Practice Severance Agreements Sex Discrimination Title VII Wrongful Termination

New Rule Permits Hospitals to Subsidize Physician Employees

A new 2016 Medicare physician payment rule allows hospitals and other provider institutions to make payments to physicians for the purpose of enabling them to employ nonphysician practitioners, such as nurse practitioners and...more

11/10/2015 - Affordable Care Act Health Care Providers Healthcare Medicare Payment Reform Stark Law

Health Facilities May Be Insuring Doctors Without Knowing It

A September 29 ruling by the New Jersey Supreme Court effectively makes a health facility liable for the professional negligence of a medical staff member who doesn’t have malpractice insurance or who has insurance that...more

10/8/2015 - Healthcare Healthcare Facilities Malpractice Insurance Medical Malpractice NJ Supreme Court Professional Liability Professional Negligence

Suing the Hand that Feeds You

Jeffrey Jacobs alleges that Idaho’s Pocatello Hospital violated the False Claims Act because of physician recruitment contracts that were overly generous to his practice group. Jeff should know because he was recruited under...more

10/7/2015 - Anti-Kickback Statute False Claims Act (FCA) Hospitals Medicaid Medicare Physicians Recruitment Incentives Recruitment Policies Reimbursements Stark Law Whistleblowers

Ky. Ruling Casts Doubt on Health Care Arbitration Agreements

Health care institutions in Kentucky may want to take a fresh look at their patient arbitration provisions, in light of a September 24 decision by the Kentucky Supreme Court. Out-of-state institutions may want to take a...more

10/2/2015 - Arbitration Arbitration Agreements Health Care Providers Hospitals KY Supreme Court Nursing Homes Power of Attorney Wrongful Death

Even Brain Surgeons Make Dumb Decisions

RHP hired Schindler to practice neurosurgery. Two years later, he developed various back-related physical issues that interfered with his ability to perform surgery. RHP took steps to accommodate him so that he could...more

9/29/2015 - Contract Interpretation Employment Contract Physicians

U.S. Third Circuit Allows Providers to Sue Health Insurers Directly

For many years, the United States Court of Appeals for the Third Circuit was out of step with its sister Courts of Appeal when it came to the issue of suing health insurance companies for failing to cover the medical expenses...more

9/18/2015 - Aetna Appeals Assignments ERISA Health Care Providers Health Insurance Insurance Industry

Two More Hospitals Qualify for Exception to Exception to Grandfather Exception to Elimination of Whole Hospital Exception to Stark...

The Stark Law generally prohibits physicians from referring Medicare and Medicaid patients to facilities in which they have an ownership interest. There used to be a “whole hospital exception” excluding entire hospitals (as...more

9/18/2015 - Affordable Care Act Anti-Kickback Statute CMS Grandfathering Rules Healthcare Hospitals Physicians Stark Law

Broward Health Wins Most-Illegal-Physician-Comp

Okay, there’s not really a Most-Illegal-Physician-Compensation Prize. But if there were, Florida’s North Broward Hospital District would have won in a walk. That’s why the district has agreed to pay the government $69.5...more

9/17/2015 - Anti-Kickback Statute False Claims Act (FCA) Healthcare Hospitals Patient Referrals Physician Compensation Arrangements Physicians Qui Tam Stark Law

Third Cir. Holds Hospitals May Sue Health Insurers Directly

Before September 11 the Third Circuit Court of Appeals had been out of step with its sister federal circuits when it came to the right of hospitals, physicians and other health providers to sue health insurers that failed to...more

9/15/2015 - Appeals Assignments Health Care Providers Health Insurance Healthcare Hospitals Insurance Industry Insurance Litigation Physicians

Another Study Undercuts Physician-Owned Hospital Suspicions

Physician-owned hospitals cherry-pick well-insured patients, disfavor Medicaid and minority patients, and charge more that their nonprofit counterparts, right? Wrong, says a new study published on September 2 by respected...more

9/7/2015 - Hospitals Physician-Owned Hospitals

Whistleblower Filed Too Early & Too Late for Share of $322M SCAN Scam Recovery

During his days as a data encounter manager at SCAN, Jim suspected the company had been double-billing Medicare and Medicaid for years. He expressed his concerns within SCAN. When he refused a job reassignment, he was fired....more

9/4/2015 - False Claims Act (FCA) Fraud Medicare Public Disclosure Qui Tam Whistleblower Awards Whistleblowers

Free Patient Parking May Trigger False Claims Act Violation

Who knew? When you park for free at your doctor’s office, you may be a pawn in a scheme to violate the Anti-Kickback Statute, the Stark Law, and the False Claims Act. It’s enough to make you sick....more

8/21/2015 - Anti-Kickback Statute False Claims Act (FCA) Hospitals Parking Lots Physicians Stark Law Whistleblowers

Hospital Chain Pays Heavy Price for Being Too Clever

Finding that Community Hospital Systems had been “too clever by half” in negotiating a global settlement agreement for seven whistleblower suits, a federal judge ordered the chain to pay the attorneys’ fees of all the...more

8/13/2015 - Attorney's Fees False Claims Act (FCA) Healthcare Hospitals Medicaid Medicare Settlement Stark Law TRICARE Whistleblowers

Court Adopts Tough Interpretation of 60-Day Repayment Rule

New York’s Mt. Sinai Hospitals can’t seem to catch a break in its long-running battle with whistleblower Bob Kane. First, the government joined the case and wanted not just the $1,000,000 in Medicaid overpayments, but an...more

8/5/2015 - False Claims Act (FCA) Hospitals Medicaid Qui Tam Software Treble Damages Whistleblowers

When Is a Hospital Not a Hospital?

Rebecca was a nurse at North Cypress Medical Center, in Texas. Back in 2011 she was treated for an eating disorder at Timberline Knolls Residential Treatment Center, in Illinois. When she sought reimbursement under the...more

8/1/2015 - Appeals Health Insurance Hospitals Nurses Prior Authorization Reversal Summary Judgment

OIG Approves Lease of Employees to Psych Hospital

On July 28 the Office of Inspector General (OIG) of Health & Human Services gave its blessing to a health system’s lease of employees to a related psychiatric system. Under the arrangement the system would also provide...more

7/30/2015 - Anti-Kickback Statute Exemptive Relief HHS Leases Medicare OIG Psychiatric Hospitals Safe Harbors Temporary Employees

Beware of Nurses Bearing Gifts

Alisia and David blew the whistle on their former employer, Nurses’ Registry & Home Health, for sending gift baskets and ticket events to doctors who referred patients to the home health operation. Their qui tam suit alleged...more

7/22/2015 - Anti-Kickback Statute Client Referrals False Claims Act (FCA) Gifts Home Health Care Nurses Physician Compensation Arrangements Physicians Qui Tam Stark Law Summary Judgment Whistleblowers

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