News & Analysis as of

Health Law Blog: CMS Offers Settlement to Hospitals for Resolving Patient Status Denials

On September 9, 2014, the Centers for Medicare & Medicaid Services (CMS) held a conference call with providers and other interested parties regarding CMS’s recent offer to resolve any acute care or critical access hospitals’...more

Special (Limited) CMS Offer to Settle Claims on Appeal

With little fanfare just before the Labor Day weekend, CMS announced a program in which it would enter into administrative agreements with eligible providers in exchange for the providers’ withdrawal of pending appeals...more

Summer Fraud and Abuse Roundup

The federal government was busy over the summer when it came to decisions and settlements under the Stark Law, anti-kickback law and federal False Claims Act. This article revisits recent developments with respect to...more

Acute Care Hospitals Settle FCA Lawsuits for $98 Million

Community Health Systems, Inc. (CHS) and Community Health Systems Professional Services Corporation, together a national owner and operator of acute care hospitals, and 119 of their hospitals, agreed to pay $98 million to...more

Defendants: Reject §998 Settlement Offers at Your Peril

Here’s a cautionary tale for all those defense attorneys who don’t take §998 settlement offers seriously enough. In a recent case in San Diego Superior Court, two teenage boys sued an outpatient services provider,...more

Lessons From Omnicare Settlement In 'Swapping' Cases

On June 25, the U.S. Department of Justice announced that it had settled with Omnicare Inc. in two matters alleging that kickbacks resulted from below-cost discounts offered to skilled nursing homes as an inducement to select...more

News from the Health Law Gurus™: July 2014

Survey of ACA Navigators Finds 10.6 Million People Sought Enrollment Help — In a survey released this week, the Kaiser Family Foundation (“Kaiser”) estimates that approximately 10.6 million people received assistance...more

HIPAA Violation Results in $4.8 Million Settlement

While most healthcare providers know to pay close attention to the HIPAA rules when setting up their information technology systems, recent events have demonstrated that this close scrutiny should also be applied to computer...more

HHS Announces $800,000 HIPAA Settlement in Medical Records “Dumping” Case

On June 23, 2014, The Department of Health and Human Services (HHS) entered into an $800,000 settlement with Parkview Health System, Inc. (“Parkview”), a nonprofit community health system servicing northeastern Indiana and...more

Health Law Alert: HIPAA Enforcement on the Rise, as OCR Audit Program Moves Forward

A recent settlement from New York—involving the largest fine levied to date in the history of HIPAA enforcement, a staggering $4.8 million imposed on two public hospitals—should remind health care providers, health plans and...more

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

Kentucky Hospital Pays $41 Million To Settle Fraud Charges

Yesterday Kentucky’s largest hospital, King’s Daughters Medical Center, in Ashland, announced its agreement to pay $40.9 million to settle charges that it committed Medicare and Medicaid fraud by billing for coronary...more

“Cha-Ching” – HIPAA Settlement Reaches New Heights and Signals More To Come

In the largest HIPAA enforcement action to date, the Department of Health and Human Services (HHS) Office for Civil Rights (OCR) extracted $4.8 million from two leading New York institutions, New York-Presbyterian Hospital...more

How Are Your Physicians Compensated? Stark Law + False Claims Act = Halifax Paying $85 Million

On March 10, 2014, just days before trial, Halifax Hospital Medical Center and Halifax Staffing, Inc. (collectively “Halifax”) entered into an $85 million settlement with the U.S. Department of Justice resolving allegations...more

News from the Health Law Gurus™ - May 2014

Massachusetts to Start from Scratch with Health Insurance Website — Massachusetts plans to abandon its health insurance exchange website in favor of starting over from scratch, according to a New York Times report....more

PJP Health to Pay $300,000 to Settle EEOC Age Discrimination and Retaliation Lawsuit

Insurance Sales Company Harassed and Terminated Employees Based on Their Age, Federal Agency Charged - NEW YORK - PJP Heath, Inc. will pay a total of $300,000 to three former employees to settle a lawsuit for age-based...more

Insurance Antitrust Legal News - May 2014 • Volume 3, Number 3

In This Issue: - LEGISLATION PERMITTING HEALTHCARE PROVIDERS TO NEGOTIATE JOINTLY WITH HEALTH INSURERS INTRODUCED IN CONGRESS: Legislation was recently introduced by Representative John Conyers (D. Michigan)...more

Theft Of Unencrypted Laptops Leads To Two HHS Settlements Totaling Nearly $2 Million

On April 22, the U.S. Department of Health and Human Services (HHS) announced settlements with both Concentra Health Services (Concentra) and QCA Health Plan, Inc. (QCA). Through these latest settlements, HHS is reiterating...more

Halifax Pays $85 Million to Resolve Improper Physician Compensation Arrangement Claims Brought by Employee-Whistleblower

Since January 2009, the DOJ has recovered more than $13.4 billion through False Claims Act cases involving fraud against federal health care programs, and last month, Halifax Hospital Medical Center and Halifax Staffing, Inc....more

First HIPAA Settlement with County Government

On March 6, 2014, the Department of Health and Human Services’ Office for Civil Rights settled potential HIPAA violations with the Skagit County Public Health Department in Washington State for $215,000. Initially, OCR’s...more

Coloplast: $16 Million to Settle 400 Transvaginal Mesh Lawsuits

While it is not official, Bloomberg is reporting that Coloplast A/S, one of the smaller manufacturers of transvaginal meshes, is said to be willing to settle a number of lawsuits for $16 million....more

Halifax Health And Government Settle False Claims Act Claims For $85 Million, But Case Is Not Over

On March 10, 2014, Halifax Hospital Medical Center and Halifax Staffing, Inc. (collectively, "Halifax") entered into a settlement agreement and a corporate integrity agreement ("CIA") to resolve claims brought under the False...more

Florida Hospital to Settle Stark Law Case for $85 Million: Tentative settlement between Halifax Hospital Medical Center and United...

The Department of Justice and Florida’s Halifax Hospital Medical Center have reached a tentative $85 million settlement in a case alleging violations of the federal physician self-referral law (commonly known as the “Stark...more

HHS Announces First HIPAA Settlement Based on Lack of Breach Notification Policies and Procedures

The Department of Health and Human Services (HHS) recently announced the first settlement under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) based on violations of the law's privacy, security,...more

NPDB Guidebook revision would clarify investigation reporting issues

Physicians always have been justifiably concerned about reports to the National Practitioner Data Bank (NPDB) regarding malpractice payments and adverse peer review actions. Two areas of frequent uncertainty have...more

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