The US Department of Health and Human Services Office of Inspector General (OIG) recently released Advisory Opinion No. 23-07, in which OIG approved a proposed arrangement to pay employed physicians bonuses based on net...more
We hope you were able to join us for our July Fast Break on the US Court of Appeals for the Fourth Circuit's recently affirmed $114 million judgment in United States v. Mallory. If not, you missed a great session, featuring...more
Powerfully illustrating the efforts of the US Department of Health and Human Services (HHS) to transform the US healthcare system to a value-based model, the Office of the Inspector General (OIG) and the Centers for Medicare...more
11/25/2020
/ Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Fraud and Abuse ,
Health Care Providers ,
Healthcare Fraud ,
Healthcare Reform ,
OIG ,
Rulemaking Process ,
Safe Harbors ,
Stark Law ,
Value-Based Care
As we noted in our previous Health Law Scan blog CMS Issues Program Instructions for Medicare Telehealth Waiver, CMS issued program instructions on March 17 to implement the Medicare telehealth waiver in response to the...more
3/20/2020
/ Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
Facebook ,
FaceTime ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Medicare ,
OCR ,
OIG ,
Public Health Emergency ,
Skype ,
Telehealth ,
Waivers
As part of emergency funding to combat the threat of the 2019 Novel Coronavirus (COVID-19), last week Congress waived many of the telehealth restrictions for Medicare services in certain situations. This monumental change...more
3/10/2020
/ Anti-Kickback Statute ,
Coronavirus/COVID-19 ,
Crisis Management ,
Emergency Management Plans ,
Emergency Response ,
Federal Funding ,
Health and Safety ,
Health Care Providers ,
Infectious Diseases ,
Legislative Agendas ,
Medicare ,
Policies and Procedures ,
Public Health ,
Stark Law ,
Telehealth
Highlighting the US Department of Health and Human Services’ (HHS) efforts to transform the US healthcare system to a value-based model, the Office of the Inspector General (OIG) and the Centers for Medicare and Medicaid...more
A new report suggests that the Stark law is obsolete in new payment models.
On June 30, the US Senate Committee on Finance (the Committee) released the report Why Stark, Why Now? Suggestions to Improve the Stark Law to...more
7/7/2016
/ Affordable Care Act ,
AHLA ,
Alternative Payment Models (APM) ,
Anti-Kickback Statute ,
Civil Monetary Penalty ,
False Claims Act (FCA) ,
Fraud Abuse and Waste ,
Health Care Providers ,
Legislative Agendas ,
Medicare ,
Medicare Access and CHIP Reauthorization (MACRA) ,
Physicians ,
Repeal ,
Stark Law
The report finds that PODs increase overutilization, lack transparency, and increase the risk of patient harm and warns that hospitals must combat the growing threat of PODs.
On May 10, the US Senate Committee on Finance...more
The proposed rule to give providers more protections to promote beneficiary access to care solicits significant industry input.
On October 2, the Department of Health and Human Services (HHS) Office of Inspector...more
10/6/2014
/ Affordable Care Act ,
Anti-Kickback Statute ,
Civil Monetary Penalty ,
Gainsharing ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Hospitals ,
OIG ,
Proposed Regulation ,
Safe Harbors