Ober|Kaler

Criminal Prosecutions of Health Care Fraud: The Stakes Continue to Rise for Individual Providers

On June 18, 2015, the U.S. Department of Justice (DOJ), in collaboration with the U.S. Department of Health and Human Services (HHS), announced criminal charges against 243 individuals located in 14 states for various health…more
| Criminal Law, Health

Provider Fights Back Against Whistleblower's Taking of Provider's Documents

Among the challenges for health care providers facing whistleblower lawsuits is the discovery that a whistleblower has secretly taken the provider’s documents or data. What options are available to the provider? In the recent…more
| Civil Procedure, Government Contracting, Health, Labor & Employment Law

Stark Litigation: The Tuomey Saga Draws to a Close

In what may be the penultimate chapter of the long–running saga of the Tuomey case, the Fourth Circuit affirmed the final judgment and award in favor of the government in its case against Tuomey Healthcare System, Inc. (Tuomey)…more
| Administrative Law, Civil Procedure, Government Contracting, Health, Nonprofit Law

OSHA Stepping Up Scrutiny of Hospitals and Inpatient Health Care Facilities

On June 25, 2015, the Occupational Safety and Health Administration (OSHA) published a Memorandum to its Compliance Officers expanding its enforcement policy regarding workplace hazards facing employees in the health care…more
| Health, Labor & Employment Law

CMS Drives Change in Quality, Physician Payment, and Stark in Proposed 2016 Physician Fee Schedule

The Centers for Medicare and Medicaid Services (CMS) took the opportunity in its annual update of the Medicare physician fee schedule (PFS) for 2016 to make a number of proposals to drive change in quality, physician payment,…more
| Health

Stark Regulations: Proposed Physician-owned Hospitals Provisions

In the proposed Physician Fee Schedule for 2016 [PDF], CMS recommends amending several requirements related to the physician-owned hospital and rural provider exceptions to the Stark law. As discussed more fully below, CMS…more
| Health

Stark Regulations: Proposed Physician Recruitment Provisions

Assistance to Employ a Non-Physician Practitioner (NPP) - Currently under the Stark law, the physician recruitment exception (42 C.F.R. § 411.357(e)) permits hospitals, Federally Qualified Health Centers (FQHCs) and Rural…more
| Health

Stark Regulations: Technical Revisions

The proposed Physician Fee Schedule for CY 2016 includes multiple technical revisions to the regulations implementing the Stark law. These revisions appear to be designed to provide greater clarity and flexibility with respect…more
| Health

Changes Are Afoot for Quality Measures and Physician Payment Provisions

In the proposed Medicare Physician Fee schedule (PFS) update for 2016, CMS announces a number of new policies, making changes to several of the quality reporting initiatives that are associated with PFS payment, and begins…more
| Health

Proposed 2016 Physician Fee Schedule Would Impact Medicare Shared Savings Program

The proposed Physician Fee Schedule for 2016 [PDF] contains several provisions that are likely to have an impact on the Medicare Shared Savings Program (MSSP). These provisions focus in large part on quality measures and the…more
| Business Organizations, Health

The Sick and Safe Leave Trend Spreads to Montgomery County (And the State of Maryland is Not Far Behind)

On June 23, 2015, the Montgomery County, Maryland Council passed the Earned Sick and Safe Leave Act requiring all private employers, including both taxable and tax-exempt entities, in the County to provide employees with sick…more
| Labor & Employment Law

Again, the OIG Approves a Medigap Policy Contract with Preferred Hospital Networks

On June 12, 2015, the U.S. Department of Health & Human Services, Office of Inspector General (OIG) issued Advisory Opinion 15-08. This opinion continues the well-established pattern of favorable advisory opinions which approve…more
| Health

It's Time to Bill Medicare: Do You Know Where Your Physicians Are?

The Department of Health and Human Services Office of Inspector General (OIG) recently reported that Medicare contractors overpaid physicians $33.4 million in incorrectly coded physician services between January 2010 and…more
| Health, Government Contracting

CMS Pays $1.3 Billion to Hospitals for Settlements of Medicare Inpatient Appeals

On June 11, 2015, CMS announced that it had entered into settlements with over 1,900 hospitals for over 300,000 disputed inpatient billing claims. CMS updated its website dedicated to inpatient hospital reviews, noting that as…more
| Administrative Law, Health

OIG Approves Charitable Organization's Patient Assistance Program

On May 28, 2015, the U.S. Department of Health & Human Services, Office of Inspector General (OIG) issued an advisory opinion approving a charitable organization’s proposal to provide financial assistance to individuals with…more
| Health, Science, Computers, & Technology, Nonprofit Law
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Contact

100 Light Street
Baltimore, MD 21202, United States

  • 410.685.1120
  • 410.547.0699

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