News & Analysis as of

Stark Law

Recent Fraud Settlements Illustrate Current Compliance Risk Areas

by Ruder Ware on

One of the reasons compliance officers and health care attorneys read fraud settlements is to identify issues the government is focused on. The cases the government decides to pursue are very indicative of the areas of fraud...more

2018 Bipartisan Budget Act Revises Stark Law Regulations – Part II

by Nossaman LLP on

The Bipartisan Budget Act of 2018 (the “Act”), signed into law on February 9, 2018, contains an amendment that should cause physicians and healthcare providers to take note. ...more

The Bipartisan Budget Act – Greater Access, Innovation, and Technology in the Administration of Medicare Advantage Plans - Part I

by Nossaman LLP on

Prior to adjourning for spring recess, Congress passed and the President signed into law on March 23, 2018, omnibus appropriations legislation that funds the government for the remainder of the fiscal year – through September...more

Continuing Resolution Creates Significant Changes to Medicare and Medicaid Policies

by Polsinelli on

The Bipartisan Budget Act of 2018, commonly referred to as the “Continuing Resolution,” was recently signed into law, creating a short-term fix to funding the federal government for six weeks while also raising the debt...more

Driving Health Care Efficiencies: Consolidate and Innovate, But Proceed with Caution

Despite the U.S. substantially outspending peer high-income nations with almost 18 percent of GDP dedicated to health care, on any number of statistical measurements from life expectancy to birth rates to chronic disease, the...more

Changes in Federal Enforcement Cases and the Stark Law May Benefit Health Care Providers

by Ruder Ware on

Some recent changes in federal law and in federal agency interpretation of federal law may both clarify and relieve some regulatory obligations of health care providers. Lessening Dependence on Federal Agency...more

Health Care : Helpful Hints – March 2018

by Burr & Forman on

Alabama Data Breach Notification Act - On March 1, 2018, the Alabama Senate voted for passage of Senate Bill 318,the Alabama Data Breach Notification Act, by a vote of 24-0. The bill is now being considered by the Alabama...more

Bipartisan Budget Act Revises Stark Law, Increases Penalties for AKS and CMP Law Violations, and Expands Telehealth Coverage

On February 9, 2018, Congress passed the Bipartisan Budget Act of 2018 (the Act), which included a number of important health law provisions.. ...more

Healthcare Fraud & Abuse Review 2017

by Bass, Berry & Sims PLC on

A LOOK BACK... A LOOK AHEAD - While the uncertainty associated with legislative efforts to repeal the Patient Protection and Affordable Care Act (PPACA) dominated most of the headlines for the healthcare industry last year,...more

Civil and Criminal Fraud and Abuse Penalties Increase and Stark Law Changes

by McGuireWoods LLP on

The Bipartisan Budget Act of 2018 (the Act) continues to ratchet up penalties for fraud and abuse violations under the Medicare and Medicaid programs. The Act doubles statutory civil fines and quadruples some criminal fines,...more

Civil and Criminal Fraud and Abuse Penalties Increase and Stark Law Changes

by McGuireWoods LLP on

The Bipartisan Budget Act of 2018 (the Act) continues to ratchet up penalties for fraud and abuse violations under the Medicare and Medicaid programs. The Act doubles statutory civil fines and quadruples some criminal fines,...more

Lifting the Limits on Physician-Owned Hospitals: Can Regulators Prevail Where Legislators Have Stalled?

We reported, in early 2017, on what was then the latest legislative effort to repeal the Affordable Care Act’s amendment to the Stark Law’s whole hospital exception, which amendment has effectively prevented new...more

New York State’s Prohibition of the Corporate Practice of Medicine – A Not-So-Gentle Reminder

by Farrell Fritz, P.C. on

Spurred in large part by the changing landscape of medicine, more and more medical professionals are seeking to become a part of something bigger. Often, they are under the misassumption that they can set up and run their...more

DOJ Memoranda Encourage Dismissal of Declined False Claims Act Cases and Prohibit Government Reliance on Noncompliance with Agency...

by Farrell Fritz, P.C. on

The Department of Justice issued two memoranda at the start of 2018 that may have important effects on health care fraud investigations and prosecutions under the False Claims Act. ...more

K&L Gates Triage: Triage in 2018: Health Care Topics to Watch in the New Year

by K&L Gates LLP on

We expect 2018 to be another year of rapid change within the health care industry. In this episode, Mary Beth Johnston highlights some of the key topics that the health care practice group will monitor in the coming year,...more

Will Centers for Medicare & Medicaid Services (CMS) Really Make Changes to the Stark Law?

by Ruder Ware on

If you navigate to the American Hospital Association (AHA) Interactive Town Hall of January 17, 2018, you can view a video in which Seema Verma, the current Administrator of the Centers for Medicare and Medicaid Services,...more

Significant Changes in Healthcare Laws Enacted Through the Bipartisan Budget Act of 2018: Stark, Civil and Criminal Penalties,...

by Dorsey & Whitney LLP on

On February 9, President Trump signed the Bipartisan Budget Act of 2018 (“BBA”) into law. The BBA funds the federal government through March 23 and included a bipartisan agreement to increase annual spending authority for a...more

Significant Health Policy Changes Contained in Bipartisan Budget Act of 2018

by King & Spalding on

On February 9, 2018, after passing the House and Senate, the President signed into law the Bipartisan Budget Act of 2018 (BBA). The BBA amends the Budget Control Act of 2011 (BCA) to increase the spending caps on both defense...more

Stark Law Reform a Focus of Recent Regulatory and Legislative Initiatives; 2018 DHS Code List and CPI-U Updates

by Dorsey & Whitney LLP on

The Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma recently identified federal physician self-referral law (or “Stark Law”) reform as a top policy priority and reported that an inter-agency group is...more

CO Senate Proposes Bills Expanding Self-Referral Prohibition And Affecting Freestanding ERs

by Husch Blackwell LLP on

Bill Would Extend Colorado Mini-Stark Law to Services Reimbursed by Private Payors On January 29, 2018, Colorado State Senator Irene Aguilar introduced SB 18-115, titled “Apply Stark Laws to Medical Referrals Outside...more

Third Circuit Rejects False Claims Act Theory that Anti-Kickback Violations "Taint" All Related Claims

by Jones Day on

The Situation: A provision in the False Claims Act ("FCA") had clarified when Anti-Kickback Statute ("AKS") violations can make a claim false, but the provision's rule of per se falsity does not answer when a claim "result[s]...more

2017 – The Health Law Year in Review

Uncertain. What better word to describe a year in which a new administration came to power and began to chart a new course for health policy, the fate of the Affordable Care Act (ACA) hung in the balance, and courts grappled...more

OIG Reaffirms Permissibility of Certain Gainsharing Arrangements

The Department of Health and Human Services Office of the Inspector General (OIG) has issued an Advisory Opinion (Opinion) in connection with a hospital’s gainsharing arrangement (Arrangement) with a designated group of...more

CMS Approves Laboratory Alerts to Physicians in Rare Stark Law Advisory Opinion

The Centers for Medicare & Medicaid Services (CMS) issued a rare advisory opinion (CMS-AO-2017-1) under the Stark Law (Section 1877 of the Social Security Act, codified at 42 U.S.C. § 1395) earlier this fall, addressing a...more

Courts May Not Review CMS’s Determination to Grant or Deny a Hospital’s Expansion Application Under Stark

by King & Spalding on

In a decision issued on November 21, 2017, the D.C. Circuit affirmed the district court determination that the Affordable Care Act (ACA) bars judicial review of CMS’s determination to grant or deny a hospital’s Stark Law...more

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