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Health Care Providers Patient Referrals

Maynard Nexsen

Insights from a Recent Court Decision

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The Eliminating Kickbacks in Recovery Act (EKRA), 18 U.S.C. § 220, is a criminal statute that prohibits knowingly and willfully soliciting or receiving remuneration for referring patients to recovery homes, clinical treatment...more

Rivkin Radler LLP

Radiology Practice to Pay $8.9M to Resolve FCA/AKS Claims

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The U.S. Attorney’s Office for the Southern District of Texas announced on August 20 that National Interventional Radiology Partners PLLC (NIRP) and its founder and CEO will pay $8,884,091 to the United States to resolve...more

Cozen O'Connor

Whistleblower Watch - Summer 2024

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Whistleblower Watch is a comprehensive source for all False Claims Act (FCA) news and information. Every quarter, Cozen O’Connor will provide in-house counsel and compliance professionals with a summary of the most notable...more

Nelson Mullins Riley & Scarborough LLP

Medicaid Overpayment Audits: What Medical Providers Need to Know

The Audit Process - While Medicaid audits are meant to ensure integrity and efficiency of the Medicaid Program, they can often be incredibly cumbersome and challenging for medical providers to navigate. During an audit,...more

Lathrop GPM

Now is Not the Time to Relax: Record Settlements in Stark Law and False Claims Cases

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In early May 2024, the University of Pittsburgh Medical Center (UPMC) agreed to pay $38 million to resolve a False Claims Act case based on alleged Stark Law violations. The size of the settlement in United States ex rel. J....more

Rivkin Radler LLP

OIG Advisory Opinion Blesses Gift Card Plan

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A recent Advisory Opinion (No. 23-15) from the U.S. Department of Health and Human Services’ Office of Inspector General (OIG) concluded that a healthcare consulting company’s plan to offer gift cards to physician practices...more

Morrison & Foerster LLP

True Facts About False Claims: MoFo's FCA Newsletter - December 2024

Designed for busy in-house counsel and compliance professionals, this newsletter seeks to bring you up to speed on key federal and state False Claims Act (FCA) developments, with links to primary resources. Each quarter, we...more

Rivkin Radler LLP

Brooklyn Cardiologist Hit with Fraud Charges

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On December 14, the U.S. Attorney’s Office for the Southern District of New York and other agencies announced the indictment of Niranjan Mittal, a Brooklyn cardiologist, on multiple fraud charges. Mittal allegedly fabricated...more

Kerr Russell

Problems With Referral Incentives Explained

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Daniel Schulte discusses why dentists should not incentivize patient referrals in The Journal of the Michigan Dental Association (November 2023). Question: I would like to add a referral incentive program to attract new...more

Stevens & Lee

U.S. Supreme Court Declines to Clarify Key Provisions of the False Claims and Anti-kickback Statutes

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Last week, the U.S. Supreme Court denied the request of qui tam relators that it review the Sixth Circuit’s recent decision in United States of America ex rel. Martin v. Hathaway, No. 22-1463 (6th Cir.). In so doing, the...more

Latham & Watkins LLP

California Supreme Court Rules on Unfair Competition Law

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The decision provides organizational plaintiffs, including nonprofits and trade associations, with a basis to establish standing to bring UCL claims. In July 2023 the California Supreme Court expanded the ability of...more

BCLP

Five years on: EKRA's legacy

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Five years ago Congress enacted the Eliminating Kickbacks in Recovery Act of 2018 (“EKRA”). Aimed at combating kickbacks in the addiction treatment industry, EKRA prohibits remunerations in return for patient referrals to...more

Holland & Knight LLP

Florida Legislature Shrinks Supervision Requirements Under Florida Mini-Stark Law

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New Florida legislation, Senate Bill 768 (2023), amending the Patient Self-Referral Act of 1992 (the Act), also known as the Florida "mini-Stark law," has been signed by Gov. Ron DeSantis and is set to take effect on July 1,...more

Fox Rothschild LLP

Brightree and MatrixCare Support Interoperability

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Brightree by ResMed (“Brightree”), a cloud-based management software platform for healthcare providers, has conducted its biannual interoperability survey, and issued its corresponding biannual Interoperability and Engagement...more

Holland & Hart - Health Law Blog

Idaho’s New Virtual Care [Telehealth] Access Act

Idaho’s new Virtual Care Access Act (the “Act”) amends Idaho’s existing law to make it easier to render telehealth in Idaho effective July 1, 2023. The requirements of the new Act are summarized below....more

Stevens & Lee

Two Recent Federal Court Cases Tackle Three Critical Components of the Anti-Kickback Statute

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Two recently decided federal court cases hone in on the proper interpretation and application of three critical components of the Anti-Kickback Statute (“AKS”), namely: •the requirement that a violation of the AKS must...more

Holland & Hart LLP

Idaho's New Virtual Care [Telehealth] Access Act

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Idaho’s new Virtual Care Access Act (the “Act”) amends Idaho’s existing law to make it easier to render telehealth in Idaho effective July 1, 2023. The requirements of the new Act are summarized below....more

Kerr Russell

Terminating the Dentist-Patient Relationship and Avoiding Abandonment

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Question: I have a patient who is very difficult to deal with. He is rude to my employees, does not always follow my treatment recommendations, complains about my fees, and is generally very unpleasant. I do not care to see...more

Nelson Mullins Riley & Scarborough LLP

The Impact of the Decision in U.S. v. Holland on the One Purpose Test

The Court’s decision in U.S. v. Holland highlights the apparent contradiction between the judicially created and often relied upon “one purpose test” involving criminal and civil enforcement actions under the Federal...more

McGuireWoods LLP

OIG Weighs in on Practices Funding Continuing Education Programs for Their Referral Sources

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On June 29, 2022, the U.S. Department of Health and Human Services Office of Inspector General (OIG) issued Advisory Opinion No. 22-14 regarding an ophthalmology practice’s proposed options to fund continuing education (CE)...more

Holland & Knight LLP

Recent Medicare Advantage Plan Settlement Highlights Anti-Kickback Statute's Breadth

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A recent settlement involving a Medicare Advantage plan should serve as a reminder that the federal Anti-Kickback Statute (AKS) is broad and far-reaching, both on its face and in practice. On July 1, 2022, the U.S. Department...more

Hendershot Cowart P.C.

Common Medical Lab Referral & Compensation Arrangements Could Lead to Criminal Charges

Hendershot Cowart P.C. on

EKRA stands for the Eliminating Kickbacks in Recovery Act, and it has become a prominent enforcement tool against fraud in the healthcare and medical testing industries. Although the law was developed in 2018 to help combat...more

Tarter Krinsky & Drogin LLP

The Anti-Kickback Statute and its Implications on Medical Practices

The Anti-Kickback Statute (AKS) protects healthcare beneficiaries from the influence of money in their medical decision-making. Overall, the AKS criminalizes renumeration “intended to induce patient referrals or influence the...more

Oberheiden P.C.

5 Tips for Lab Compliance in 2023

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In many ways, the COVID-19 pandemic increased the business opportunities available to clinical labs, including molecular and respiratory labs. As the nation—and the world—struggled to develop adequate testing infrastructure,...more

Rivkin Radler LLP

Texas Hospital Settles Alleged FCA Violations for $18.2 Million

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The U.S. Department of Justice (DOJ) announced that Flower Mound Hospital Partners LLC, a partially physician-owned hospital in Flower Mound, Texas, agreed to pay $18.2 million to settle its alleged violations of the False...more

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