News & Analysis as of

Halifax Health Gets In More Hot Water

You probably didn’t think Florida’s Halifax Health could make its situation any worse. After all, only two months ago Halifax agreed to pay $85 million to settle just the first half of a Medicare fraud case. That still...more

The Seven Ages of Retirement

Important decisions in planning retirement income and expenses can be made at seven ages, and the decisions made at those ages can have a substantial effect on the quality of retirement....more

MedPAC Recommends “Site-Neutral” Payment Policy

The Medicare Payment Advisory Commission’s (MedPAC) June report to Congress contained several cost-cutting recommendations but one of the more significant ones was its proposal to move “immediately” to “site-neutral payment”...more

2013 Healthcare Fraud and Abuse Bootcamp Webinar Series, Part V: Compliance

Bill Mathias of Ober|Kaler's Health Law Group presented on compliance as a part of the 2013 Healthcare Fraud and Abuse Bootcamp Webinar Series sponsored by the American Health Lawyers Association. This webinar...more

CMS Issues Final Rule on Medical Loss Ratio for Medicare Advantage and Part D

On May 23, 2013, CMS issued its Final Rule on Medical Loss Ratio (MLR) requirements for Medicare Advantage (MA) and Medicare Part D programs. MLR calculates the percentage of revenue used by MA organizations and Part D...more

A “Stark” Result for South Carolina Hospital: Stark Law Violations May Cost Up to $357 Million in Penalties

After a four-week retrial, a federal jury concluded on May 8, 2013 that Tuomey Healthcare System (Tuomey) violated both the Stark Law and the False Claims Act (FCA). The jury determined that Tuomey violated the Stark Law by...more

Sixth Circuit Applies Strict Precondition of Payment Requirement to Reverse $11.1 Million FCA Judgment

The U.S. Court of Appeals for the Sixth Circuit, in United States ex rel. Hobbs v. MedQuest Associates, Inc., 711 F.3d 707 (6th Cir. April 1, 2013), recently reversed an $11.1 million False Claims Act (“FCA”) judgment,...more

Understanding The Impacts Of The Patient Protection And Affordable Care Act

While many of the key provisions and requirements of "Obamacare" (otherwise known as the Patient Protection and Affordable Care Act ("ACA")) do not go into effect until 2014, there is much that can be done in 2013 to...more

CMS Issues Final Physician Payment Sunshine Act Regulations

On February 1, 2013, the Centers for Medicare and Medicaid Services (CMS) published the long-awaited final regulations implementing the Physician Payment Sunshine Act (Act or Sunshine Act). The Sunshine Act requires drug,...more

CMS Issues Final Physician Payment Sunshine Rule

In an action that will have broad implications for drug and device manufacturers, researchers, distributors, teaching hospitals and physicians, on February 1, the Centers for Medicare and Medicaid Services (CMS) publicly...more

Employment Law Update: Healthcare; 401(k) Plan Fee Disclosures and Fiduciary Responsibilities; & Other Recent Changes

In This Presentation: - Healthcare - 401(k) Plan Fee Disclosures and Fiduciary Responsibilities - Fair Labor Standards Act - Data Privacy Issues Please see full presentation below for more...more

What Do Healthcare Reform and the "Fiscal Cliff" Have In Common? Tax Increases

On June 28th, the U.S. Supreme Court upheld the new healthcare reform law in part by ruling that the individual mandate is a tax and Congress has authority to impose the individual mandate under Congress’s taxing power. As a...more

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