Compliance Perspectives: Changes to the Physician Self-Referral and Anti-Kickback Rules
Providers will often pay physicians for serving in important administrative roles within the organization. Compensation for administrative services can create risk to the organization under multiple laws, including the...more
700 Pharmacy v. Bureau of Workers’ Compensation Fee Review Hearing Office & SWIF; No. 660 C.D. 2020; No. 617 C.D. 2020; filed May 16, 2024; President Judge Cohn-Jubelirer - In this case, 700 Pharmacy filed five Fee Review...more
Bernice Bennett v. Jeld Wen, Inc. (WCAB); No. 1454 C.D. 2022; filed Oct. 6, 2023; President Judge Cohn Jubelirer (previously unreported and designated reported by Order dated Dec. 15, 2023) - The claimant settled a 2010 work...more
The Centers for Medicare & Medicaid Services (CMS) recently released data on its 2023 settlements of voluntary self-disclosures related to past violations or potential violations of the physician self-referral law (the Stark...more
On November 29, 2023, the Centers for Medicare & Medicaid Services (CMS) published the 2024 annual update to the designated health services (DHS) Code List. This annual update includes important changes for Medicare providers...more
From 1998-2008, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) published compliance program guidelines for various industries in the Federal Register....more
The Centers for Medicare and Medicaid Services (CMS) recently updated the publicly available information regarding the Self-Referral Disclosure Protocol (SRDP) settlements to include aggregate settlement data from calendar...more
In a rarely seen “unfavorable” advisory opinion, the United States Department of Health and Human Services Office of Inspector General (“OIG”) recently warned that an entity’s (“Requestor”) proposal to assist surgeons in...more
Florida Senate Bill 768 (SB 768) amends the Florida Patient Self-Referral Act of 1992 (PSRA), which regulates financial arrangements between referring healthcare providers and providers of healthcare services. This amendment,...more
Valuations, and how a business reacts to them, directly impact a business’s ability to complete successful transactions. In the healthcare sector, compliance with federal and state laws against self-referral and kickbacks and...more
As a part of the Consolidated Appropriations Act, 2023 (CAA), Congress passed new exceptions to the Physician Self-Referral Law (Stark Law) and the federal Anti-Kickback Statute (AKS) allowing certain healthcare entities to...more
At the end of 2022, Congress enacted the Consolidated Appropriations Act of 2023 (“CAA”), for which there has been much fanfare. As it relates to health care, this legislation included provisions addressing issues such...more
On March 29, 2023, the Department of Justice’s (DOJ) Office for the Eastern District of Michigan announced a notable set of three settlements (collectively, the Settlement) in excess of $69 million dollars total with a...more
This issue of McDermott’s Healthcare Regulatory Check-Up highlights significant regulatory activity and developments occurring in January 2023, including several criminal and civil enforcement actions related to the federal...more
Following the comment period that ended on August 8, 2022, the Centers for Medicare and Medicaid Services (CMS) recently finalized changes to the Self-Referral Disclosure Protocol (SRDP) for physician practices to disclose...more
The Centers for Medicare & Medicaid Services (CMS) published updates to the CMS Voluntary Self-Referral Disclosure Protocol (SRDP) on January 23, 2023. The SRPD is the CMS process for Medicare providers and suppliers to...more
Based on recent changes and clarifications made by the Centers for Medicare and Medicaid Services (CMS) in the Federal Physician Self-Referral Law (commonly known as the “Stark Law”), hospitals and health systems need to...more
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
On June 9, 2022, the Centers for Medicare and Medicaid Services (CMS) solicited comments to proposed changes to the Self-Referral Disclosure Protocol (SRDP) for physician practices disclosing group practice noncompliance....more
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
On June 9, 2022, the Centers for Medicare & Medicaid Services announced an opportunity for the public to comment through Aug. 8, 2022, on its voluntary self-referral disclosure protocol (SRDP). The voluntary SRDP is a way to...more
The Centers for Medicare & Medicaid Services (CMS) recently issued an advisory opinion under the federal physician-self referral law (the “Stark Law”) (Advisory Opinion No. CMS-AO-2021-2) (the “Advisory Opinion”) clarifying...more
The final rules regarding special compensation under 42 U.S.C. § 1395nn, the Physician Self-Referral or Stark Law, go into effect on January 1, 2022 and will require many physician group practices to modify their compensation...more
In an advisory opinion posted November 10, 2021 (AO 21-15), the Office of the Inspector General of the United States Department of Health and Human Services (OIG) appeared to soften a disturbing position that it had taken in...more
Earlier this month, the Centers for Medicare and Medicaid Services (CMS) released its final rules for the 2022 Medicare Physician Fee Schedule (PFS Final Rule) and 2022 Medicare Hospital Outpatient Prospective Payment System...more