Robert Wolin

Robert Wolin

BakerHostetler

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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

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 Care Providers Health Insurance 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 Health Care Providers

“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 - Health Care Providers Healthcare 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

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