Robert Wolin

Robert Wolin


Contact  |  View Bio  |  RSS

Latest Publications


Dialing for Dollars Yields Conviction for Home Health Telemarketer

Sundae Williams, the owner of Serenity Marketing Inc., made unsolicited phone calls to recruit patients, including Medicare beneficiaries, for contracted home health agencies. Williams and Serenity then referred those...more

9/27/2016 - Fraud Home Health Agencies Kickbacks Medicare Unsolicited Phone Calls

Obstruction of a Medicare Audit Doesn’t Require Direct Obstruction of a Federal Agent

A registered pharmacist, the owner of two Alabama pharmacies, pleaded guilty to obstructing a 2012 federal audit of Medicare claims and agreed to pay a $2.5 million penalty to the government. The submission of the false and...more

9/14/2016 - Audits Falsified Documents Guilty Pleas Medicare Medicare Part D Reimbursements

Medicare Advantage Plan Arbitration Clauses Preempted by Medicare Appeals Process

The Arizona Supreme Court, in an interesting case involving a Medicare-related coverage dispute between a Medicare Advantage plan administrator, United Behavioral Health (UBH), and two inpatient psychiatric care providers,...more

9/13/2016 - Appeals Arbitration ERISA HHS Medicare Medicare Advantage Preemption

Assault of Home Health Worker by a Patient’s Father Prompts OSHA Violation

A provider of pediatric home health, Epic Health Services, was recently fined $98,000 by the Occupational Safety and Health Administration (OSHA) in connection with the sexual assault of a home health employee by a patient’s...more

8/29/2016 - Home Healthcare Workers Negligence OSHA Punitive Damages

Ambulance and Home Health Moratorium Continued and Expanded

The Centers for Medicare and Medicaid Services (CMS) recently announced an extension of its temporary moratorium on enrolling new nonemergency ambulance suppliers in New Jersey, Pennsylvania and Texas and new home health...more

8/29/2016 - Ambulance Providers CHIP CMS Home Health Agencies Moratorium

Does the Medical-School-to-Prison Pipeline Widen in Middle Age?

The trend of holding physicians personally responsible for healthcare crimes has continued unabated over the past year. As noted in a previous article, physicians are particularly attractive targets for federal prosecutors...more

6/9/2016 - Criminal Prosecution DOJ Health Care Providers Healthcare Fraud Kickbacks Medicaid Medicare Money Laundering USCIS

Insurer Actions Cut the Heart Out of Out-of-Network Providers

Aetna Life Insurance Company recently won a $37 million verdict against a group of Northern California surgical centers, Bay Area Surgical Management, LLC and its affiliates (collectively, Bay Area), for an alleged...more

4/22/2016 - Aetna Antitrust Violations False Billing False Claims Act (FCA) Health Insurance Healthcare Fraud Insurance Industry Kickbacks Medical Reimbursement Out of Network Provider Physicians

I’ll Gladly Pay You 10 Years From Today for Care Already Provided

Most providers whose claims have been determined to be improper by the Recovery Audit Contractors (RACs) under the Medicare Recovery Audit Program have discovered that the appeals backlog “is incontrovertibly grotesque.”...more

4/8/2016 - Health Care Providers HHS Medicare Medicare Claims Appeals Process Recovery Audit Recovery Audit Contractors (RACs)

Kickbacks and Commercial Bribery: Another Touchstone to Consider

The latest indictment confirms that fraud and abuse analysis is about more than just the federal and state healthcare anti-kickback statutes. The U.S. Attorney for the Northern District of New Jersey has just charged the 26th...more

4/4/2016 - Anti-Kickback Statute Bribery Health Care Providers Travel Act Wire Fraud

Debt Collector for Affiliated Physician Group Can Rely on Patient Contact Consent Obtained by Hospital

Careful drafting of consent and information release provisions can ensure that providers and affiliated physicians and their debt collectors can contact patient cell phones using automatic telephone dialing systems or...more

3/28/2016 - Auto-Dialed Calls Debt Collection FCC Health Care Providers Hospitals Prior Express Consent TCPA

Drug Manufacturer Discount Cards: Accept With Caution

Pharmaceutical manufacturer discount card usage by government program beneficiaries has been an active area for government action in recent years. In a September 2014 Special Advisory Bulletin, the U.S. Department of Health...more

2/4/2016 - Anti-Kickback Statute Discount Pricing False Claims Act (FCA) Medicaid Medicare OIG Pharmaceutical Industry Pharmacies Prescription Drugs

Medicare: Congress Ends 2015 With Some Last-Minute Reforms

Congress chose to end 2015 with some last-minute Medicare reforms impacting healthcare providers. Significantly, the Patient Access and Medicare Protection Act, signed into law by President Obama on December 28, 2015,...more

1/19/2016 - CMS Healthcare Reform Identity Theft MACs Medicare New Legislation

Solicitation of New Safe Harbors and Special Fraud Alerts

The U.S. Department of Health and Human Services Office of Inspector General (OIG) recently announced its annual solicitation of proposals and recommendations for developing new, and modifying existing, safe harbor provisions...more

1/19/2016 - Anti-Kickback Statute Health Care Providers OIG Safe Harbors

The Deeper Dive: Guarding Against Unrealistic Goals and Organizational Pressures That Can Lead to Compliance Failure

When misconduct occurs within an organization, it is often reported and interpreted as an anecdote involving a few rogue employees who are quickly identified and appropriately disciplined. Misconduct derives, at least in...more

12/7/2015 - Board of Directors Compliance Corporate Governance Department of Veterans Affairs Healthcare

Hello Budget Agreement; Goodbye Provider-Based Status?

H.R. 1314, the Bipartisan Budget Act of 2015, was signed into law by President Obama on November 2, 2015. The two-year budget framework, which raises the federal debt limit through March 2017, partially rolls back the Budget...more

11/9/2015 - Affordable Care Act Bipartisan Budget Healthcare Physician Medicare Reimbursements Section 340B

Don’t Flush the Drugs! The EPA is Coming!

The Environmental Protection Agency (EPA) recently issued a pre-publication Proposed Rule (40 C.F.R. part 266, subpart P) regulating the management and disposal of drugs deemed “hazardous waste pharmaceuticals” by healthcare...more

9/28/2015 - DEA EPA FFDCA Hazardous Waste Health Care Providers Healthcare Illegal Drugs Pharmaceutical Industry RCRA Safe Drug Disposal

NLRB: Nurses Entitled to Union Representation at Peer Review Meeting

The NLRB, in an August 27, 2015, decision, held that two nurses who were requested to voluntarily appear before a hospital’s Nursing Peer Review Committee were entitled to have their union representatives attend the peer...more

9/15/2015 - Disciplinary Proceedings Healthcare Hospitals Licenses NLRB Nurses Peer Review Union Representatives Unions Work Suspensions

Waivers of Co-Pays and Deductibles: Insurance Benefit Exclusions Grow

Recent changes to policy and plan language and increased litigation by third-party payers suggests that out-of-network providers who waive co-pays and deductibles may be in for some rough sailing. Providers must be aware of...more

8/19/2015 - Co-payments Health Care Providers Health Insurance Healthcare Hospitals Kickbacks Medical Reimbursement Out of Network Provider Patients Third-Party Waivers

The Deeper Dive in Texas: Recent Appellate Court Decisions Affecting Providers

For this edition of the Deeper Dive, we travel to Texas for a look at some interesting cases involving healthcare providers decided on appeal in 2015. Some of these decisions may be surprising – and perhaps even troubling –...more

8/4/2015 - Anti-Competitive Breach of Duty Fiduciary Duty Fraud Health Care Providers Healthcare Hospitals Medical Liability Non-Compete Agreements Physicians Recruitment Policies Tortious Interference TX Supreme Court

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 Health Care Providers Healthcare 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 Industry 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

66 Results
View per page
Page: of 3

"My best business intelligence, in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:

Sign up to create your digest using LinkedIn*

*By using the service, you signify your acceptance of JD Supra's Privacy Policy.

Already signed up? Log in here

*With LinkedIn, you don't need to create a separate login to manage your free JD Supra account, and we can make suggestions based on your needs and interests. We will not post anything on LinkedIn in your name. Or, sign up using your email address.