Physicians

News & Analysis as of

Record $17M Settlement Of False Claims Act Lawsuit Alleging Doctor Kickbacks

Hailed as “another achievement” for the government’s Health Care Fraud Prevention and Enforcement Action Team (referred to as “HEAT”), the U.S. Department of Justice has announced that a Florida skilled nursing company and...more

Recent DOJ and OIG Actions Show Growing Federal Scrutiny of Physician Financial Arrangements

Over the last month the Office of Inspector General (OIG) of the Department of Health and Human Services and the Department of Justice (DOJ) have each taken actions that suggest an increasing appetite to examine the financial...more

“Ain’t Wastin’ Time No More”* — Doctors, Vets, and Lawyers in the Antitrust Crosshairs

Supreme Court Decision in North Carolina State Board of Dental Examiners v. Federal Trade Commission Prompts Legal Challenges to State Professional Boards - Earlier this month a Texas federal district court judge granted a...more

Minnesota Joins 9-State Compact Expediting Telemedicine Across State Lines

Effective July 1, 2015, Minnesota will join the Interstate Medical Licensure Compact, a group attempting to expedite the licensing of physicians seeking to provide telemedicine services to patients located in other states....more

Employee, Worker or Self-Employed?

In Suhail v Barking Havering & Redbridge NHS Trust UKEAT/0536/13/RN, the Employment Appeal Tribunal (EAT) considered whether a doctor who provided his services to a health care trust through a co-operative was an employee, a...more

Court Upholds CMS' Prohibition on 'Under-Arrangements' Transactions, Strikes Down CMS' Prohibition on 'Per-Click' Equipment Rental...

A 2008 rule change from the Centers for Medicare and Medicaid (CMS)—which effectively prohibited referring physician-owned companies from furnishing hospital services “under arrangements”—has withstood a challenge by a...more

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

Structuring Healthcare Provider Agreements for Compliance

On June 23rd, the Healthcare Law Blog discussed the Fraud Alert recently issued by the Office of Inspector General of the United States Department of Health and Human Services regarding physician compensation arrangements...more

Senior Justice Officials Warn Healthcare Companies That They Will be Held Accountable for the Misconduct of Their Employees and...

On Thursday, June 18, 2015, Attorney General Loretta Lynch announced that the Medicare Fraud Strike Force, in conjunction with seven local U.S. Attorney’s Offices, had charged 243 individuals, across 17 federal districts, in...more

Variables Affecting Medical PL Settlement Values [Video]

From the 2015 PLUS Medical PL Symposium session “Batch Claims: What are the ‘Three P’s?’,” Scott Crockett, Esq. of Wagstaff & Cartmell discusses the variables that impact claim settlement, including “fear of” claims....more

Federal court blocks rule restricting telemedicine practice in Texas

A federal court has temporarily enjoined the Texas Medical Board (TMB) from implementing and enforcing a rule restricting the practice of telemedicine pending resolution of an antitrust lawsuit filed by Teladoc, Inc. The...more

New Law Continues to Require Out-of-Network Facility-Based Physicians to Notify Patients of Mediation Rights

Early last week, Gov. Greg Abbott signed SB 481 into law. The new law, which will become effective on September 1st, gives Texas consumers the option to mediate medical bills that they receive from out-of-network...more

Physicians Face Increased Anti-Kickback Enforcement Focus

It appears that the Office of Inspector General (“OIG”) now has physicians squarely in the crosshairs of one of its most powerful enforcement tools: the Anti-Kickback Statute (“AKS”). The AKS is a criminal statute with...more

There's A Difference Between "Confidential And Proprietary Information" And A Trade Secret

I can't remember the last time that the Business Court granted a motion opposing the designation of a case as a mandatory complex business case. And since the Business Court Modernization Act went into effect in October...more

Increased OIG Scrutiny on Medical Directorships

On June 9, 2015, the Department of Health and Human Services Office of Inspector General (OIG) released a Fraud Alert entitled, "Physician Compensation Arrangements May Result in Significant Liability." The Alert is an...more

Telemedicine: Hitting a Few Speed Bumps

Despite faster Internet connections, better software, increased availability of devices with built-in video, and an increasingly tech-savvy public, the broad acceptance of telemedicine—the use of telecommunication and...more

OIG Now Targeting Physician Compensation Arrangements

In a Fraud Alert issued on June 9, 2015, the U.S. Department of Health and Human Services Office of Inspector General (OIG) notified the healthcare community that physician compensation arrangements are on the OIG’s radar...more

TelaDoc Wins Injunction Against Texas Medical Board re: Telehealth Restrictions

The Federal District Court of the Western District of Texas has ruled against the Texas Medical Board and granted TelaDoc’s Motion for a Preliminary Injunction prohibiting the Texas Medical Board from enforcing new rules...more

Blog: FDA Launches New REMS Website

The U.S. Food and Drug Administration (FDA) launched this week REMS@FDA, a Risk Evaluation and Mitigation Strategy (REMS) database website. The new, user-friendly website contains a table of all currently approved individual...more

OIG Fraud Alert Serves as Stern Warning to Physicians Regarding Compensation Arrangements

Emphasizing its continued focus on physician compensation arrangements, the OIG issued a Fraud Alert on June 9, 2015, warning that physicians risk significant penalties if medical directorships and other compensation...more

OIG Issues Fraud Alert to Warn Hospitals and Physicians

On June 9, 2015, the OIG issued a Fraud Alert entitled “Fraud Alert: Physician Compensation Arrangements May Result in Significant Liability”. This is just a one page letter warning hospitals and physicians by stating the...more

Miami Nursing Home To Pay Record $17M in Whistleblower Suit

A Miami-based nursing home network agreed Tuesday to pay a record $17 million to settle a False Claims Act suit brought by its former CFO, accusing it of running a kickback scheme. The case is United States of America et al...more

Government Announces Health Care Fraud “Takedown”

Earlier today, Attorney General Loretta Lynch announced the largest coordinated crackdown in the Medicare Fraud Strike Force’s eight-year history. The government brought charges against 243 individuals for approximately $712...more

An Unforgiving NLRB Holds That Protecting Patient Data Under HIPAA Can Still Violate Section 7 Rights

It would make sense that the systems housing patient records at a physician’s office should be protected by a robust duty on the part of the physician’s employees to keep such records confidential. The purpose, of course, is...more

OIG Fraud Alert: Physicians in the Cross Hairs

On June 9, 2015, the Department of Health and Human Services Office of Inspector General (OIG) issued a Fraud Alert focused on physician relationships. The Alert cautions physicians who enter into compensation arrangements...more

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