News & Analysis as of

Physician Ownership

Whiteford

Corporate Practice of Medicine, Antikickback and Stark Analysis After the AAEM-PG and Envision Settlement

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The American Academy of Emergency Medicine Physician Group (AAEM-PG) recently settled a lawsuit in United States District Court for the Northern District of California against Envision Healthcare and Envision Physician...more

Butler Snow LLP

Rural Emergency Hospitals: Relief for the Weary?

Butler Snow LLP on

On December 27, 2020, the Centers for Medicare & Medicaid (“CMS”) of the Department of Health and Human Services created a new provider type for embattled rural and critical access hospitals (“CAHs”)—the Rural Emergency...more

Stevens & Lee

OIG Says Proposed Surgery Monitoring Arrangement May Violate Kickback Statute

Stevens & Lee on

On August 18, the Office of Inspector General in the Department of Health and Human Services (“OIG”) issued Advisory Opinion 23-05 in which it concluded that a proposed arrangement involving the formation of a company...more

MoFo Life Sciences

States Extend Scope Of Regulatory Oversight Of Health Care Entities

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The proliferation of private investor-backed management of health care practices continues to draw scrutiny from regulators into the impact on patient care, health care costs, and access to services. State regulators play a...more

Oberheiden P.C.

MSO Investigations: When Are Physician-Owners at Risk?

Oberheiden P.C. on

The U.S. Department of Justice (DOJ) has recently taken a renewed interest in management services organizations (MSOs), including physician-syndicated MSOs in which physician-owners provide medical services in exchange for...more

McDermott Will & Emery

[Event] Physician Practice Management and ASC Symposium 2023 - April 11th - 12th, Nashville, TN

McDermott Will & Emery on

We are excited to return to Nashville for McDermott’s annual Physician Practice Management and ASC Symposium. Join us and participate in: - Exclusive networking and deal-making opportunities with industry leaders, including...more

Stevens & Lee

Federal Case Details How a Relator-Whistleblower Satisfies the False Claims Act’s “Original Source” Requirement

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An important threshold question in qui tam cases under the False Claims Act is whether the relator-whistleblower is the original source of the information forming the basis for the claim. This is because qui tam actions under...more

Stevens & Lee

Selling Your Health Care Practice? Consider Timing and Effort Before Saying “Yes”

Stevens & Lee on

For a number of reasons, the calendar is among the most effective tools for advancing a transaction from “potential transaction” to a “closed transaction,” and that holds particularly true in the final months of the year. For...more

Paul Hastings LLP

Buyers Take Note: OIG Opinion Provides Insights on Physician-Owned Entities & Their Technologies

Paul Hastings LLP on

PART I- On April 20, 2022, the Office of Inspector General (“OIG”) of the Department of Health and Human Services (“HHS”) issued Advisory Opinion, No. 22-07 (“Opinion 22-07”), an informative opinion regarding arrangements...more

McDermott Will & Emery

[Webinar] Critical Access Hospital and Rural Emergency Hospitals: Proposed Rules and Opportunity for Input - August 23rd, 12:30 pm...

McDermott Will & Emery on

Beginning in 2023, Medicare will recognize a new provider type: the Rural Emergency Hospital (REH). The establishment of REHs is intended to preserve access to emergency departments and other outpatient services in rural...more

Hendershot Cowart P.C.

Investing In or Opening an Ambulatory Surgery Center? Beware of State & Federal Regulations

Hendershot Cowart P.C. on

Investment in ambulatory surgery centers (ASCs) is soaring. Physicians, hospitals, and health systems are attracted by the high margins, significant growth potential, payer influence, and efficient patient care. Beyond...more

Rivkin Radler LLP

NY Medical Practice Settles False Claims Act Allegations Related to “Incident-To” Billing

Rivkin Radler LLP on

On August 3, North Country Neurology, P.C., a physician-owned medical practice located in Watertown, NY (the “Practice”), reached a settlement with the U.S. Attorney’s Office for the Northern District of New York to pay...more

Dickinson Wright

[Webinar] Safeguarding Your Practice: 2022 Fraud and Abuse Updates - November 10th, 1:00 pm - 2:00 pm EST

Dickinson Wright on

This presentation will provide an update on significant changes in significant cases related to the Stark Law, Civil Monetary Penalties Law, and the Anti-Kickback Statute....more

Bass, Berry & Sims PLC

CMS Proposes New Stark Law Exception for Rural Emergency Hospitals

Bass, Berry & Sims PLC on

On July 15, the Centers for Medicare & Medicaid Services (CMS) published the Calendar Year 2023 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgery Center (ASC) Payment System proposed rule...more

ArentFox Schiff

Physician Ownership in Medical Device Company Will Not Trigger Anti-Kickback Statute Enforcement Action, OIG Concludes in Advisory...

ArentFox Schiff on

Physician-owned companies that generate revenue from the sale of medical devices ordered by their physician owners have in recent years been the target of federal fraud and abuse enforcement actions. OIG Advisory Opinion...more

Bass, Berry & Sims PLC

OIG Approves Arrangement Involving Physician-Owned Device Manufacturer— Distinguishes Prior Special Fraud Alert on Physician-Owned...

Bass, Berry & Sims PLC on

On April 25, the Office of Inspector General (OIG) for the U.S. Department of Health and Human Services published Advisory Opinion 22-07, approving an arrangement whereby physicians hold ownership interests in a medical...more

McDermott Will & Emery

[Event] 2022 Physician Practice Management & ASC Symposium - March 31st - April 1st, Nashville, TN

McDermott Will & Emery on

Join us in person in Nashville for the Physician Practice Management and ASC Symposium! You don’t want to miss this exclusive conference addressing the critical business, transactional and regulatory issues impacting the...more

Winstead PC

Top 5 Takeaways from Winstead’s Physician Roll-up Transactions Event

Winstead PC on

In September, Winstead hosted a virtual event entitled “Physician Roll-Up Transactions.” During the event, the speakers explored some of the different strategies, trends, and challenges surrounding physician roll-up...more

Bass, Berry & Sims PLC

CMS Advisory Opinion Provides Flexibility Under Stark for Group Practice Structures Involving Wholly-Owned Physician Practice...

Bass, Berry & Sims PLC on

The Centers for Medicare & Medicaid Services (CMS) recently issued Advisory Opinion No. CMS-AO-2021-01, clarifying that physician groups that furnish designated health services (e.g., laboratory, imaging) through wholly-owned...more

McGuireWoods LLP

Healthcare Headlines Episode 2 - PPM Trends: Successful Integration of Physician Practices

McGuireWoods LLP on

Hosted by McGuireWoods partner Amber McGraw Walsh, chair of the firm’s nationally recognized Healthcare Department, the second episode of "Healthcare Headlines" focuses on successful integration strategies for physician...more

Epstein Becker & Green

Should You Sell Your Medical Practice to Private Equity? Five Critical Considerations for Physician Groups - Thought Leaders in...

Epstein Becker & Green on

Private equity (PE) investment in physician groups has steadily grown over the last several years, with 219 physician group deals being announced or closed last year. This trend leaves some groups wondering, is PE for us?...more

McDermott Will & Emery

Strategies for Maximizing Physician Practice Management Investments

Private equity continues to fuel robust activity in the physician practice management (PPM) sector. Within the last five to seven years, not only have PPMs within traditional areas of medicine proliferated, but new...more

McDermott Will & Emery

[Event] 2019 Physician Practice Management & ASC Symposium - May 7th-8th, Nashville, TN

Join us for the 2019 Physician Practice Management & ASC Symposium, a two-day, high-level conference addressing the critical business, transactional and regulatory issues that impact the growth and profitability of the PPM...more

Tucker Arensberg, P.C.

CMS Proposes New Stark Exceptions: Timeshare Lease

Tucker Arensberg, P.C. on

In July 2015, CMS released proposals to provide several new Stark Law exceptions and to clarify issues regarding existing exceptions. Over the next few days, I will post comment on what I consider the most significant new...more

McDermott Will & Emery

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

McDermott Will & Emery on

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

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