Norman Tabler, Jr.

Norman Tabler, Jr.

Faegre Baker Daniels

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The Law Doesn’t Forbid Submitting False Claims

An Eighth Circuit decision provides a reminder that the False Claims Act doesn’t forbid submitting false claims: it forbids knowingly submitting false claims. That made all the difference in an appeal of summary judgment in...more

8/25/2016 - CMS False Claims Act (FCA) Health Care Providers Medicare Summary Judgment

Anti-Kickback Regs Near Approval, After Only 19 Years

The White House is reviewing proposed regulations to ease restrictions on certain financial arrangements between hospitals and physicians and on certain transactions between providers and patients. The proposed regulations,...more

8/25/2016 - Affordable Care Act Anti-Kickback Statute Bi-Partison Balanced Budget Act (BBA) Civil Monetary Penalty Hospitals OMB Physicians Safe Harbors

HHS Proposes 340B Dispute Resolution Process

From its inception the 340B program has been the subject of disputes between drug manufacturers and their safety-net hospital customers. On August 12 HHS proposed an administrative process for resolving those...more

8/25/2016 - Affordable Care Act Drug Pricing HHS HRSA Pharmaceutical Industry Section 340B

Policy for Employee Theft Including Forgery Doesn’t Cover Employee Forgery

A seller extends $90 million in credit to a customer, secured by letters of credit. When the debtor can’t pay, the seller discovers the instruments are fakes, forged by its own employee. Can the seller recover under a...more

8/24/2016 - Debtors Declaratory Judgments Forgery Letter of Credit Popular Summary Judgment

EMTALA Plaintiff Trips Over State Law Requirement

If you bring a case in federal court alleging violation of federal law, you might assume that you needn’t be concerned with procedural requirements of state law. But you could be wrong. Just ask Cynthia...more

8/22/2016 - EMTALA Health Care Providers Hospitals Statute of Limitations

Hold it, Doctor! Don’t Hit the Send Button!

The Joint Commission made a big splash when it issued its “Update: Texting Orders” back in the spring. That Update rescinded the accrediting organization’s long-standing prohibition on sending physician orders via text...more

8/19/2016 - CMS Health Care Providers Physicians Text Messages

Arbitrator to Decide Whether Arbitrator to Decide

Who gets to decide who gets to decide whether a claim can be arbitrated? That was the question before the California Supreme Court—not whether a claim can be arbitrated, but who gets to decide that question? Is it an...more

8/19/2016 - Arbitration Arbitration Agreements Arbitrators Race Discrimination

What’s In a Name? Or, the Importance of Emphasis

I.A. Khair of New Jersey ran an ambulance company called K&S Invalid Coach. Presumably, “Invalid” was pronounced IN-va-lid, with the emphasis on the first syllable. Maybe it should have been pronounced in-VAL-id, with the...more

8/18/2016 - Ambulance Providers Fraud Health Care Providers Medicaid Medicare

Hospital Demands to Be Malpractice Defendant

Why would a hospital and one of its physicians demand that a case against them be branded a malpractice case? Why would they sue the trial court to force it to call the action a malpractice case? A recent Nevada case...more

8/8/2016 - Health Care Providers Hospitals Medical Malpractice Physicians

Doctor Gets $4.6M for Blowing Whistle on Over-Compensated Doctors

Neurologist Dr. David Hammett will receive $4,590,000 as part of a settlement entered into by Lexington Medical Center (LMC) of West Columbia, S.C., and the federal government. Ironically, the hefty compensation comes as a...more

8/4/2016 - False Claims Act (FCA) Settlement Agreements Stark Law Whistleblower Awards Whistleblowers

Flying Pigs and False Claims

On July 7 the Fourth Circuit invoked Flying Pigs to vacate a lower federal court judgment in a Medicaid false claim case, even though neither the lower court nor any of the parties asked it to. The case started in 2007,...more

7/14/2016 - Anti-Kickback Statute Medicaid Qui Tam Settlement Agreements

Same Per-Click Rule, New Rationale

On July 7 CMS issued a proposed rule reaffirming its position that the Stark Law prohibits “per-click” rent payments when the lessor is the one referring the patients to the lessee for the “click,” e.g., the test or...more

7/12/2016 - CMS Equipment Lease Medicare Pay-Per-Click Stark Law

Pharmacy Settles Claim for Filling Forged Rx’s, as Trend Continues

There was a time when liability—criminal or civil—for drug abuse or forged prescriptions usually lay only with the abuser or the forger and those who actively helped them. Those days are long gone. First, we had PDMPs...more

7/8/2016 - CVS Drug & Alcohol Abuse Opioid Pharmaceutical Industry Physicians

Hospital Liability for Life-Saving Efforts?

Hospitals are in the business of saving lives. So they don’t usually face liability for trying to do just that. But a July 5 Georgia Supreme Court decision is a reminder that it’s up to the patient—not the hospital or...more

7/8/2016 - Fiduciary Duty GA Supreme Court Health Care Providers Hospitals Professional Negligence

When Damages May Exceed the Statutory Med Mal Cap

Dr. Steven Nathanson is the defendant in a medical malpractice case involving the death of a patient. On June 24 the court rejected his motion for summary judgment on his claim that punitive damages are barred by West...more

7/6/2016 - Health Care Providers Medical Malpractice Punitive Damages Summary Judgment

Ruling Puts Teeth in Antitrust Claims Against Dentistry Board

Remember the U.S. Supreme Court’s decision against the North Carolina Board of Dentistry last year? The court ruled that a state dentistry board composed mostly of practicing dentists may not have state-action immunity from...more

7/5/2016 - First Amendment Fourteenth Amendment Motion to Dismiss Standing Treble Damages

Clinics Pay Heavy Price for Failing to Audit Claims

Health clinics may want to review their auditing obligations and practices in light of a June 23 ruling by the Eleventh Circuit. Allstate decided to look into the billing practices of a group of Florida health clinics. ...more

7/1/2016 - Allstate False Billing Fraud Negligent Misrepresentation Unjust Enrichment

Where’s the Crime in Providing Free Medical Care?

Can it be a crime to provide free medical care? That’s the question presented by a post-conviction motion by the so-called King of Nursing Homes, Dr. V. Kuchipudi. Dr. K was convicted on nine counts of violating the...more

6/28/2016 - Anti-Kickback Statute Medicare Patient Referrals Physicians

Nurse’s Age Discrimination Case May Proceed

A California federal court has rejected a hospital’s motion for summary judgment in a case brought by a former nurse who claims she was fired for being too old. Seventy-year-old Lavon Ramsey had worked at Fairchild...more

6/28/2016 - Age Discrimination HIPAA Hiring & Firing Summary Judgment

When Inside Knowledge Is a Handicap to a Whistleblower

Here’s a riddle: The whistleblower is a former employee of the defendant, with inside knowledge of the operations at the heart of his qui tam suit. How can that inside knowledge be a handicap in pressing his claim? A June...more

6/27/2016 - False Claims Act (FCA) Medicaid Medicare Qui Tam Rule 9(b) Whistleblowers

Broad Examination of Narrow Networks: First-of-Its-Kind Study Examines Hospitals in Medicare Advantage Plans

On June 20, 2016, The Kaiser Family Foundation issued the first ever broad-based study of Medicare Advantage hospital networks. The study — "Medicare Advantage Hospital Networks: How Much Do They Vary?"— analyzed 409 plans in...more

6/23/2016 - HMOs Hospitals Medicare Medicare Advantage

Court Rejects Qui Tam Attack on Standard On-Call Contract

On June 10 the Third Circuit affirmed a lower court’s dismissal of a physician’s qui tam action against Pottstown Memorial Medical Center (PMMC) for violating the Anti-Kickback Statute (AKS) and False Claims Act (FCA). And...more

6/16/2016 - Anti-Kickback Statute Corporate Counsel False Claims Act (FCA) Health Care Providers On-Call Employees Qui Tam

False Claims Charges vs. Eye Clinic Sufficiently Specific

Michael Sorenson is an optometrist formerly employed by Outreach Diagnostic Clinic. After he quit, he filed a False Claims action against the eye clinic and the two doctors who owned it. He alleged that the clinic routinely...more

6/9/2016 - False Claims Act (FCA) Health Care Providers Medicare Motion to Dismiss

8th Cir. Rejects Dr.’s Grab-Bag Retaliation Suit

Dr. Alaa Elkharwily lost his job at Albert Lea Clinic, but he didn’t go quietly. He sued the clinic and eight related organizations and individuals alleging just about everything a terminated doctor can allege in Minnesota:...more

5/26/2016 - EMTALA Retaliation Summary Judgment Termination

And You Thought RAC Audits Couldn’t Get Any Worse

If there’s one thing that unites the hospital industry—even the fiercest competitors—it’s hatred of audits by recovery audit contractors, or RACs. Why? For one thing, because RACs operate on a contingency fee basis. They...more

5/25/2016 - CMS Contingency Fees GAO Hospitals Recovery Audit Contractors (RACs)

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