Introduction -
Polsinelli proudly introduces the Health Care Fraud and Abuse 2023 Year in Review, a comprehensive examination of the evolving landscape surrounding the False Claims Act (“FCA”) and fraud & abuse enforcement...more
4/12/2024
/ Anti-Kickback Statute ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Fraud and Abuse ,
Health Care Providers ,
Health Technology ,
Healthcare Fraud ,
Home Health Care ,
Hospice ,
Hospitals ,
Laboratories ,
Long Term Care Facilities ,
Medicaid ,
Medicare Advantage ,
Nursing Homes ,
Pharmaceutical Industry ,
Physicians ,
Prescription Drugs ,
Qui Tam ,
Settlement ,
Settlement Agreements ,
Skilled Nursing Facility ,
Stark Law
The Centers For Medicare & Medicaid Services Issues New Inpatient Prospective Payment System Final Rule -
On September 3, 2020, the Centers for Medicare & Medicaid Services (CMS) issued the fiscal year (FY) 2021 Medicare...more
12/31/2020
/ Centers for Medicare & Medicaid Services (CMS) ,
Cramdown ,
Drug Pricing ,
Health Care Providers ,
Healthcare Reform ,
Inpatient Prospective Payment System (IPPS) ,
Medicaid ,
Medicare ,
Physician Fee Schedule ,
Physician Medicare Reimbursements ,
Section 340B ,
Telehealth ,
Value-Based Care
The U.S. Equal Employment Opportunity Commission (the “EEOC”) sued Yale New HavenHospital (“Yale Hospital” or the “Hospital”) on February 11, 2020, alleging the Hospital is in violation of the Age Discrimination in Employment...more
The COVID-19 pandemic has created severe financial and operational difficulties for hospitals. Rapidly responding to a novel pathogen within a declared Public Health Emergency (PHE), while experiencing decreased revenues as a...more
With the New Year comes new medical staff leaders and a new set of growing pains. Contrary to what many of us believe, some simple steps can lessen the pain.
...more
1/17/2020
/ Anti-Competitive ,
Antitrust Violations ,
Breach of Contract ,
Covenant of Good Faith and Fair Dealing ,
Defamation ,
Due Process ,
Electronic Communications ,
Employee Evaluations ,
Equal Protection ,
Genuine Issue of Material Fact ,
Health Care Providers ,
Healthcare Facilities ,
Healthcare Workers ,
Hospitals ,
Leadership ,
Negligence ,
Patient Safety ,
Peer Review ,
Physicians ,
Retaliation ,
Summary Judgment ,
Text Messages ,
Third-Party Beneficiaries ,
Tortious Interference ,
Work-Product Doctrine
Through two separate notices of proposed rule-making (NPRMs), the Centers for Medicare & Medicaid Services (CMS) and the Department of Health and Human Services (HHS) Office of Inspector General (OIG), seek to remove...more
11/13/2019
/ Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Comment Period ,
Department of Health and Human Services (HHS) ,
Fee-for-Service ,
Health Care Providers ,
Healthcare Fraud ,
Healthcare Reform ,
NPRM ,
OIG ,
Proposed Rules ,
Risk-Based Approaches ,
Rulemaking Process ,
Safe Harbors ,
Stark Law ,
Value-Based Care
Polsinelli is pleased to share the Health Care Reimbursement and Payor Dispute Update. This newsletter is a designated source of news, information and guidance on the constantly evolving reimbursement industry.
...more
11/1/2019
/ Administrative Appeals ,
Centers for Medicare & Medicaid Services (CMS) ,
Contract Disputes ,
Enrollment ,
Health Care Providers ,
Injunctive Relief ,
Managed Care Contracts ,
Medical Reimbursement ,
Medicare ,
Payor Contracts ,
Revocation ,
Site-Neutral Exception ,
Universal Health Services Inc v United States ex rel Escobar
Starting today, the industry has 75 days to provide input on the proposed rules published in the Federal Register regarding the future enforcement of the Anti-Kickback Statute (AKS). ...more
10/21/2019
/ ACOs ,
Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Comment Period ,
Cybersecurity ,
Department of Health and Human Services (HHS) ,
Health Care Providers ,
Health Information Technologies ,
Healthcare Reform ,
OIG ,
Proposed Regulation ,
Regulatory Agenda ,
Rulemaking Process ,
Safe Harbors ,
Stark Law ,
Telehealth ,
Value-Based Care