Health Law, Government Contracting

CMS Prevails in DSH Challenge Involving Waiver-Expansion Days

by Thomas W. Coons | Ober|Kaler on 5/22/2013

Over the years, CMS and its contractors have wrestled with how days approved under a Medicaid demonstration project should be counted, if at all, for purposes of the Medicare disproportionate share hospital (DSH) calculation....more

OIG Releases Updated Provider Self-Disclosure Protocol

by John T. Bentivoglio, Jennifer L. Bragg, Maya Florence, Michael K. Loucks, Gregory M. Luce | Skadden, Arps, Slate, Meagher & Flom LLP on 5/21/2013

On April 17, 2013, the Office of the Inspector General (OIG) of the United States Department of Health and Human Services released an updated Provider Self-Disclosure Protocol (SDP). As self-described, OIG updated the SDP to...more

OIG Updates Special Advisory Bulletin on the Effect of Exclusion from Participating in Federal Health Care Programs

by Ropes & Gray LLP on 5/15/2013

On May 8, 2013, the Office of Inspector General of the Department of Health and Human Services (“OIG”) released an Updated Special Advisory Bulletin on the Effect of Exclusion from Participation in Federal Health Care...more

OIG Issues Updated Bulletin on Exclusion from Federal Health Care Programs

by Aaron Graham | Bradley Arant Boult Cummings LLP on 5/14/2013

On May 8, 2013, the Office of Inspector General (OIG) issued an updated Special Advisory Bulletin on the effect of exclusion from federal health care programs. A federal health care program (e.g., Medicare and Medicaid) is...more

OIG Updates Special Advisory Bulletin on the Effect of Exclusion from Federal Health Programs

by Julie Kass | Ober|Kaler on 5/14/2013

On May 8, 2013, the OIG issued an update that supersedes and replaces its 1999 Special Advisory Bulletin, The Effect of Exclusion from Participation in Federal Health Care Programs. The updated bulletin continues to stress...more

PODs Beware: OIG Releases Special Fraud Alert

by Matthew Murer | Polsinelli on 5/10/2013

The Office of the Inspector General (OIG) released a Special Fraud Alert on March 26, 2013 warning that physician-owned distributorships (PODs) are "inherently suspect" under the Anti-Kickback Statute (AKS). Generally...more

EEOC Hears Testimony Concerning Employer Wellness Programs and the Need for Agency Clarification

by Matt Nusbaum | Proskauer - Government Contractor Compliance... on 5/8/2013

Leslie Silverman, former EEOC Commissioner, now Co-Chair of Proskauer’s Government Regulatory and Contract Compliance Group, was part of a panel that testified before the EEOC today concerning the need for clearer guidance...more

Let the Seller Beware: Hospitals Treating HMO Patients Employed by the Federal Government are “Subcontractors” Governed by...

by Theodore A. Olsen | Sherman & Howard L.L.C. on 5/6/2013

When a health plan/HMO ("Plan") provides group health coverage to employers, including the federal government, the hospitals that treat federal employees under a contract with the Plan are government "subcontractors" subject...more

Self-Audit Results Found Sufficient to Sustain False Claims Act Complaint

by Robert Mazer | Ober|Kaler on 5/2/2013

District Court Finds That Medical Group’s Failure to Further Investigate Audit Results May Violate Requirement to Return Overpayments - Background - Internal audits of third-party payment claims – frequently...more

OIG Issues Revised Provider Self-Disclosure Protocol

by Cameron Ellis, Jay Hardcastle, Judd Harwood, Christopher Puri, Jack Selden | Bradley Arant Boult Cummings LLP on 5/2/2013

On April 17, 2013, the Office of Inspector General (OIG) of the United States Department of Health and Human Services (HHS) revised its Provider Self-Disclosure Protocol (SDP), originally published in 1998, and updated in...more

Healthcare Update, No. 2, May 2013 - Court Upholds OFCCP's Jurisdiction Over Healthcare Providers

by Cheryl Behymer, Richele Taylor | Fisher & Phillips LLP on 5/1/2013

A federal district court has confirmed the position of the Office of Federal Contract Compliance Programs (OFCCP) finding that three hospitals providing medical services to U.S. government employees, and receiving payments...more

CMS Proposes to Increase Awards for Non-Qui Tam Whistleblowers

by Ellyn L. Sternfield | Mintz Levin - Health Law on 5/1/2013

CMS wants to change the way that it rewards non-qui tam whistleblowers who report alleged fraudulent or unlawful conduct related to Medicare or Medicaid. Using an IRS program as a model, CMS recently proposed rule changes to...more

Playing Cards With a Government That Stacks the Deck - D.C. District Court Radically Expands The "Christian Doctrine" To...

by David Gallacher, Franklin Turner | Sheppard Mullin Richter & Hampton LLP on 4/30/2013

On March 30, 2013, the U.S. District Court for the District of Columbia issued a decision imposing certain socio-economic contract requirements on subcontractors operating hospitals associated with the University of...more

OFCCP Enforcement Powers Expanded Over Healthcare Industry

by Amanda Pennington, Jaime Ramon, Caleb Wood | K&L Gates LLP on 4/29/2013

In a case closely monitored by the healthcare industry, a recent decision from the United States District Court for the District of Columbia expanded the jurisdiction of the Office of Federal Contract Compliance Programs...more

Sixth Circuit in MedQuest: No FCA Liability for Violation of Medicare Conditions of Participation Without Violation of Conditions...

by Calvin Marshall | Chambliss, Bahner & Stophel, P.C. on 4/26/2013

On April 1, 2013, the U.S. Court of Appeals for the Sixth Circuit overturned an $11.1 million False Claims Act (FCA) judgment by the U.S. District Court for the Middle District of Tennessee against MedQuest Associates, Inc.,...more

District Court Sides With DOL in Dispute Over Whether Healthcare Providers Are Government Contractors

by Ellen Shadur Gross | BakerHostetler on 4/24/2013

In a significant victory for the U.S. Department of Labor (DOL), the U.S. District Court for the District of Columbia recently found providers of healthcare services are subject to federal equal employment opportunity...more

Hospital And Physician Compliance With Anti-Kickback And Stark Restrictions

by Michael Volkov on 4/24/2013

A bribe is a bribe. It is not as easy as it sounds. Not all payments of money or transfers of value are bribes. The FCPA tells us that. It is even more complicated when trying to navigate Anti-Kickback and Stark law...more

OIG Releases Updated Self-Disclosure Protocol

by King & Spalding on 4/24/2013

On April 17, 2013, the U.S. Department of Health and Human Services Office of Inspector General (OIG) released an updated Provider Self-Disclosure Protocol (Protocol) that supersedes and replaces the protocol published in the...more

The Top 10 Things You Need To Know About The OIG’S Revised Self-Disclosure Protocol

by Laurence Freedman, Laura Laemmle-Weidenfeld | Patton Boggs LLP on 4/23/2013

On Wednesday, April 17, 2013, the Department of Health and Human Services’ Office of Inspector General (OIG) released an updated Self-Disclosure Protocol (SDP) governing the process by which health care providers can...more

Arrests Made and Investigation Underway at a Chicago Hospital

by King & Spalding on 4/23/2013

On April 16, 2013, the United States Department of Justice (DOJ) and U.S. Attorney’s Office in the Northern District of Illinois announced the arrest in Chicago of the owner and senior executive of Sacred Heart Hospital...more

Sixth Circuit Holds Physician Supervision and Enrollment Issues Are Not Conditions of Payment for Purposes of FCA Liability

by Darby C. Allen, B. Scott McBride | BakerHostetler on 4/23/2013

The Sixth Circuit Court of Appeals recently issued a decision overturning an $11.1 million False Claims Act (FCA) verdict against MedQuest Associates, Inc. (MedQuest) for submitting claims to Medicare in violation of the...more

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Health Law › Government Contracting