Robert Wolin

Robert Wolin

BakerHostetler

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Texas Medicaid Managed Care: Expedited Credentialing Requirement Added Along With Additional Oversight and Accountability

The Texas Legislature in Senate Bill 760 removed barriers to Medicaid recipients receiving healthcare services and required improved access for services through managed care plans. Expedited Provider Credentialing - The...more

7/13/2015 - Compliance Credentialing Healthcare Healthcare Providers Managed Care Contracts MCOs Medicaid

The Deeper Dive: C-Suite to Prison Pipeline

In recent years, the U.S. Department of Justice (DOJ) has been criticized for failing to prosecute executives for fraud, particularly in the financial sector. In response, the DOJ has begun to more heavily emphasize...more

6/29/2015 - Ambulance Providers CEOs DOJ Durable Medical Equipment Enforcement Enforcement Actions Fraud Healthcare Fraud Home Health Agencies Hospitals Medicare Personal Liability Pharmaceutical Manufacturers Pharmacies White Collar Crimes

“Ring my friend, I said you call Doctor Robert, day or night he'll be there”*

The first lawsuit, in what may be a wave of antitrust litigation challenging professional board regulations in the wake of the U.S. Supreme Court’s decision in North Carolina State Board of Dental Examiners v. Federal Trade...more

5/8/2015 - Antitrust Litigation Antitrust Provisions NC Board of Dental Examiners v FTC Physicians SCOTUS Telehealth

The Medical-School-to-Prison Pipeline Continues to Widen

Physicians now appear to be more than ever at a greater risk of investigation for healthcare crimes, largely due to their “gatekeeping” function concerning a patient’s need for medical services and the government’s increased...more

4/28/2015 - Criminal Prosecution Healthcare Physicians

Five Things to Know About the Medicare SGR Fix

H.R. 2, the Medicare Access and CHIP Reauthorization Act (MACRA), was signed into law by President Obama on April 16, 2015. A broad bipartisan compromise measure, MACRA repeals the much-maligned sustainable growth rate (SGR)...more

4/27/2015 - CHIP Health Care Providers Hospitals Medicare Medicare Access and CHIP Reauthorization (MACRA) Physician Medicare Reimbursements Physician SGR Formula

Volunteer Directors and Officers Liable to Facility Creditors

The Third Circuit Court of Appeals recently upheld a trial court’s jury verdict finding the individual board members and officers of a non-profit healthcare facility personally liable to the facility’s creditors. The board...more

3/31/2015 - Board of Directors Breach of Duty Corporate Officers Healthcare Healthcare Facilities Insolvency Non-Profits Personal Liability Volunteers

The ACA Five Years Later: A Good Investment or Risky Business? We Dare Not Opine!

The enactment of the Patient Protection and Affordable Care Act (ACA), signed into law on March 23, 2010, represents a significant legislative milestone in healthcare reform and a continuing communications challenge for...more

3/27/2015 - Affordable Care Act Health Insurance Healthcare Providers Healthcare Reform Investors

State Health Regulatory Bodies Have Teeth Pulled

Old and new regulations established by state professional boards that are composed of “active market participants” such as physicians, dentists and therapists, may be subject to antitrust challenge following the U.S. Supreme...more

3/16/2015 - Antitrust Litigation Dentists FTC Healthcare Professionals

“PhysTexting” Is Not Enough to Form a Patient-Physician Relationship

The Texas Medical Board is proposing to modify its disciplinary rules to more specifically define the requisites for a physician-patient relationship required for prescribing. Under the proposed revision to 22 T.A.C. § 190.8,...more

2/19/2015 - Electronic Prescribing Healthcare Physicians Text Messages

Who Decides When Medicaid Payment Rates Are Not Enough?

In 2005, the Florida Pediatric Society, the Florida Association of Pediatric Dentists, and a number of parents and guardians on behalf of their individual children in the Medicaid program brought suit against the state of...more

1/19/2015 - Affordable Care Act Healthcare Medicaid Medical Reimbursement

CMS Releases New Proposal to Improve Accountable Care Organizations

The Centers for Medicare and Medicaid Services (CMS) recently released a proposed rule aimed at revitalizing accountable care organizations (ACOs) under the Medicare Shared Savings Program (MSSP). Given the low level of ACOs...more

12/15/2014 - ACOs CMS Medicare Shared Savings Program

2015 Medicare OPPS and ASC Final Rule

On November 10, 2014, the Centers for Medicare and Medicaid Services (CMS) published the Outpatient Prospective Payment System (OPPS) final rule for 2015. The rule updates CMS’s payment rates and policies, value-based...more

11/25/2014 - Ambulatory Surgery Centers CMS Final Rules Hospitals Medicare Medicare Part D OPPS

Obligations During the Ebola Crisis: Ethical and Practical Considerations

Providers and health professionals face many challenges in the shifting sands of the Ebola response, including the extent of their duties to each other and their patients and their obligations under a myriad of laws,...more

11/3/2014 - ADA Best Management Practices CDC Ebola Employer Liability Issues EMTALA Ethics FMLA Health Care Providers Hospitals OSHA Physicians Title VII

Dot-com: A Health Professional's Website Is Not Just Another Website

Many physicians and other health professionals maintain a robust Internet presence, including websites and portals to provide patients with information. However, I was recently reminded of how easy it is to overlook the...more

9/23/2014 - Healthcare Healthcare Professionals Physicians Websites

Hospital’s Failure to Abate Patient and Visitor Violence Against Employees Results in OSHA Penalty

Hospitals, remarkably, are one of the most hazardous places to work. According to the U.S. Bureau of Labor Statistics, hospital workers have an estimated rate of 8.3 assaults per 10,000 workers compared to an estimated 2...more

8/27/2014 - Assault Employer Liability Issues Enforcement Actions Hospitals NIOSH OSHA Workplace Hazards Workplace Violence

Blog Exclusive: Government Sues Hospital for Birthing Mama’s Babies

The Clinica de la Mama case could well serve as an instruction manual of what not to do to stay out of the government’s crosshairs. In this case, several hospitals entered into contracts for Clinica de la Mama to provide...more

8/26/2014 - Anti-Kickback Statute Federal Contractors Healthcare Hospitals

Government Sues Hospital for Birthing Mama’s Babies

The Clinica de la Mama case could well serve as an instruction manual of what not to do to stay out of the government’s crosshairs. In this case, several hospitals entered into contracts for Clinica de la Mama to provide...more

8/19/2014 - Healthcare Healthcare Fraud Hospitals Medicare

Clash of the Circuits: Federal Exchange Subsidies at Risk?

These four words “established by the state,” at first blush do not appear obtuse or particularly vague. But these four words form the basis for the latest challenges to the Affordable Care Act (ACA) and have resulted in two...more

7/25/2014 - Affordable Care Act Halbig v Burwell Health Insurance Exchanges Healthcare IRS King v Burwell Subsidies Tax Credits

Changing Financial Landscape for Medical Debts of the Uninsured

The implementation of the ACA has afforded many with the opportunity to obtain insurance coverage. Despite the opportunity, a large number of individuals have either chosen not to enroll in a health plan or have been unable...more

6/17/2014 - Affordable Care Act Health Insurance Exchanges Healthcare HFMA Medical Expenses

Federally Qualified Health Centers: Welcome to PPS

CMS recently finalized a new PPS for Federally Qualified Health Center (FQHC) services. The implementation of the PPS was mandated by the ACA. Medicare currently pays FQHCs an all-inclusive rate for the professional...more

5/19/2014 - CMS FQHC Healthcare Medicare Advantage Patient Prospective Payment System

IPPS Proposed Rule: Read Once, Then Take an Aspirin

The Centers for Medicare and Medicaid Services (CMS) has set its sights on the quality of care during hospital inpatient stays and much, much more. On May 15, 2014, CMS published a proposed rule that would update Medicare...more

5/16/2014 - CMS Healthcare Healthcare Reform Hospitals Inpatient Billing IPPS Long-Term Care Medicare

So Much for Stop, Drop and Roll: CMS Proposes New Fire Safety Update

CMS has announced a proposed rule updating Medicare/Medicaid fire safety standards. In particular, CMS proposes to adopt the National Fire Protection Association’s (NFPA) 2012 edition of the Life Safety Code (LSC) and the...more

5/8/2014 - CMS Medicaid Medicare Safety Precautions

Do You Know What Your Hospital Board Members Are Doing?

David Chandler was appointed to serve as chairman of Tri-Lakes Medical Center (TLMC), a community hospital in Panola County, Mississippi. As chairman, Chandler set board meeting agendas, regularly dealt with the administrator...more

4/7/2014 - Anti-Kickback Statute Board of Directors Compliance Fraud Healthcare Hospitals Kickbacks Personal Liability

CMS’s Civil Defense Won’t Let You Hide Under Your Desk

The Centers for Medicare and Medicaid Services (CMS) have proposed new emergency preparedness requirements for healthcare providers and suppliers. These new requirements are designed to address the effect of a broad range of...more

3/21/2014 - CMS Disaster Preparedness Healthcare Natural Disasters

Never Fear Regulatory Violations – Focus on Conditions to Payment

The U.S. Court of Appeals for the Fourth Circuit recently upheld the dismissal of a False Claims Act (FCA) suit against Omnicare, Inc., in which the relator alleged that certain drugs repackaged by Omnicare’s subsidiary were...more

3/11/2014 - False Claims Act FDA Healthcare Medicaid Medical Reimbursement Medicare Pharmaceutical Prescription Drugs

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