Norman Tabler, Jr.

Norman Tabler, Jr.

Faegre Baker Daniels

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Supreme Court Looks to Socrates' Trial to Rule in Favor of Whistleblowers

On May 26, 2015, the United States Supreme Court issued a decision favoring whistleblowers in False Claims Act cases, basing its decision in part on the status of the trial of Socrates. ...more

6/3/2015 - False Claims Act Federal Contractors First-to-File KBR (formerly Kellogg Brown & Root) KBR v US ex rel Carter Popular SCOTUS Whistleblowers Young Lawyers

Supreme Court Renders Good News-Bad News Whistleblower Decision

Yesterday’s U.S. Supreme Court decision is good news and bad news for both whistleblowers and government contractors, including health care providers–a win for whistleblowers on one important issue, for contractors on...more

5/28/2015 - False Claims Act Federal Contractors First-to-File KBR (formerly Kellogg Brown & Root) Qui Tam SCOTUS Statute of Limitations Wartime Suspension of Limitations Act Whistleblowers

Fraud So Complicated It Takes a Neurosurgeon

Generally, when a doctor is convicted for fraud, the misdeeds are limited to a single category of fraud. Maybe the doctor charged for procedures that weren’t performed; maybe there were kickbacks for referrals; or maybe...more

5/28/2015 - Criminal Prosecution Fraud Kickbacks Medical Devices Physician-Owned Distributors Physicians

Hospitals Rally to Defend 340B

A consortium of hospitals from across the country has delivered a letter to Congressional leaders, urging them to preserve the federal 340B program in its present form. Neither the content nor the timing of the letter was...more

5/22/2015 - 21st Century Cures Initiative Health Care Providers Healthcare Hospitals Legislative Committees Prescription Drugs Section 340B

Out of the Mouths of Babes: Millions of Medicaid Dollars

Last Monday the Office of Inspector General of Health & Human Services posted a hair-raising report. “Questionable Billing for Medicaid Pediatric Services in California” raises alarming questions about the billing practices...more

5/20/2015 - Dental Practice Healthcare Healthcare Fraud Medicaid OIG

Sen. Health Committee Chairman Blasts “Whimsical” Health Agency Guidance

Sen. Lamar Alexander, chairman of the Senate Health, Education & Labor Committee, has issued letters to the Department of Health & Human Services and a number of federal agencies, requesting information about their procedures...more

5/15/2015 - HHS Legislative Agendas New Guidance

House Bill Says 23 Years Isn’t Long Enough for Transition to ICD-10

All across the country hospitals have been bracing for the scheduled Oct. 1, 2015, transition from ICD-9 coding to ICD-10. It had been scheduled for Oct. 1, 2014, but the Protecting Access to Medicare Act of 2014 delayed it...more

5/14/2015 - Health Insurance Healthcare Hospitals ICD Codes ICD-10 Medicaid Medicare World Health Organization

Good Medicine Doesn’t Always Taste Good

One of the first healthcare lessons we learn as children is that good medicine doesn’t necessarily taste good. In fact, sometimes the best medicine tastes pretty bad....more

5/13/2015 - Healthcare Hospitals Rating System

4th Cir. Sides with Surgeon in Disability Policy Dispute

On May 5 the Fourth Circuit reversed a District Court decision upholding Lloyd’s of London’s rescission of a Maryland surgeon’s disability policies. Lloyd’s had rescinded the policies because the surgeon gave false answers...more

5/12/2015 - Appeals Disability Insurance Rescission

Hospital Says Injury Was Malpractice, Plaintiff Insists It Wasn’t

Here’s an interesting riddle. When a plaintiff sues a hospital for an injury, why would the hospital insist the injury was caused by malpractice? Even more puzzlingly, why would the plaintiff insist she was not the victim...more

5/12/2015 - Health Claims Healthcare Medical Malpractice Slip and Fall St. Luke's

New CMS Ruling on DSH Appeals for FY 2004 and Earlier

It’s a measure of the backlog in DSH (for Disproportionate Share Hospital) payment appeals that CMS is still issuing rulings for appeals applicable to treatment of patients before October 1, 2004. On April 24 CMS issued...more

4/30/2015 - Appeals CMS DSH Dual Eligibility Healthcare Hospitals Medicaid Medicare

OIG Issues Compliance Guidelines for Governing Boards

On April 20, 2015, the Office of Inspector General (OIG) of the Department of Health & Human Services issued new compliance guidance for governing boards of hospitals and other health care organizations....more

4/23/2015 - Board of Directors Chief Compliance Officers Corporate Governance Health Care Providers Healthcare Facilities Hospitals OIG

Whistleblower Pays Price for Frivolous Suit

On Wednesday of this week, the federal court for the Southern District of New York rejected Fox’s plea to spare it from the $169,000 bill submitted by the white shoe law firm that successfully defended Managed Health Care...more

4/17/2015 - Frivolous Lawsuits Whistleblowers

The Enemy of My Enemy Is My Friend

We don’t normally think of American Hospital Association and the Federation of American Hospitals as friends. After all, the AHA represents nonprofits, while the FAH represents for-profits. ...more

4/3/2015 - American Hospital Association Federation of American Hospitals Hospitals Non-Profit Hospitals Physician Hospital Organizations Physicians Stark Law

Medicaid Decision Makes Strange Bedfellows

The Idaho Medicaid program scored a victory in the United States Supreme Court today, and did it by persuading normally liberal Justice Breyer to enter the conservative tent reliably inhabited by Justices Scalia, Thomas,...more

4/1/2015 - Armstrong v Exceptional Child Center Health Care Providers Healthcare Medicaid Medicaid Act Preemption Private Right of Action SCOTUS Supremacy Clause

Late Notice of Claim Costs Kentucky Hospital $10 Million

A federal court in Kentucky ruled on March 17 that Ashland Hospital had forfeited $10 million of insurance coverage because it was late in notifying its insurance company of the claim....more

3/23/2015 - Claims Made Policy D&O Insurance Hospitals Late Notices

The Cost of Health Care Isn’t the Price of Health Care

It’s common to use the term “cost of health care” to mean the price of health care. But there is a difference—often a huge difference....more

3/18/2015 - Employer Liability Issues Healthcare Workplace Injury

OIG Wants CMS to Take a Scalpel to Surgery Costs

The Office of Inspector General (OIG) of Health & Human Services is recommending that CMS make a major reduction to the amount it pays hospitals for certain kinds of surgery. ...more

3/18/2015 - CMS Healthcare Hospitals Medicare OIG Surgery

Prescriptions for the Headache of High Cost Drugs

A March 11 policy conference in Washington produced some creative thinking about the problem of high-cost specialty drugs. And on the same day, the RAND Corp. think tank released a study on the subject, “Borrowing for the...more

3/13/2015 - Debt Financing Drug Manufacturers Healthcare Costs Pharmaceutical Prescription Drugs RAND

Pro Se and Ex Rel. Don’t Mix, Even for Attorney Whistleblowers

William Verrinder filed a False Claims Act against three of America’s biggest companies—Wal-Mart, Sears and Rite-Aid—claiming they charged Medicare for expired drugs. Since he’s a lawyer himself, he filed pro se. That way he...more

3/11/2015 - False Claims Act Pro Se Litigants Rite Aid Sears Wal-Mart Whistleblowers

There’s No Such Thing as Bad Publicity

As of March 3, Solvay Pharmaceuticals is ready to second P.T. Barnum’s famous dictum that there’s no such thing as bad publicity. That’s the day a federal court in Texas dismissed a qui tam action against Solvay....more

3/10/2015 - Dismissals Kickbacks Off-Label Promotion Pharmaceutical Physicians Qui Tam Solvay Pharmaceuticals Whistleblowers

Attention Seniors! Check Into a Hospital and Get $100!

OIG Advisory Opinion 15-03 approves a Medigap insurer’s program that, among other things, calls for (a) network hospitals to waive the deductible for Medicare enrollees, (b) the insurer to pay the hospital network a fee each...more

3/4/2015 - Health Insurance Healthcare Hospitals Medicare Medigap OIG

Florida Hospitals Face Glenn Close-Like Threat

Remember the evil Glenn Close character in Fatal Attraction? We were sure Michael Douglas had drowned her in the bathtub, but she popped up again, still alive and scary as all get-out. Class actions by uninsured...more

3/3/2015 - Breach of Contract Class Action Hospitals Unfair or Deceptive Trade Practices

Peer Review Concludes with Termination of Reviewer

You read that correctly: the hospital fired the physician who did the reviewing in a medical staff peer review proceeding. Hospital executives present at the proceeding felt the reviewing physician was too harsh in...more

2/27/2015 - Confidentiality Hiring & Firing Hospitals NM Supreme Court Peer Review Physicians Private Right of Action Termination

These Doctors Work Hard – Over 24 Hours a Day

Sir Arthur Conan Doyle might have called it “The Case of the Doctors Who Work More than 24 Hours a Day.” Unfortunately for the physician group in question, Sir Arthur wasn’t the author; the federal court for the Northern...more

2/26/2015 - False Claims Act Health Care Providers Healthcare Hospitals Physician Medicare Reimbursements Physicians

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