Articles and Blogs

In a previous article, we reported on CMS’s implementation of new billing edits that will Return to Provider any hospital UB-04 claims that identify a service location that is not an exact match to a Medicare-enrolled location identified in Provider Enrollment, Chain and Ownership System. The implementation date was set to begin in April of 2020….Read More

On March 24, 2020, the U.S. Department of Health and Human Services (“HHS”) Office of Inspector General (“OIG”) began reaching out to many hospital administrators to inquire about how they are responding to the COVID-19 national emergency as part of OIG’s planned projects (“Work Plan”). OIG has suggested that these requests are part of its…Read More

The Southern District of Indiana recently held that a whistleblower must present sufficient evidence to support each alleged false claim, not just one, to survive summary judgment.[1] This holding is a win for FCA defendants that deal in a high volume of claims submitted to the government—like hospitals—and requires whistleblowers to identify every claim before…Read More

Due to the strain on the entire health care system caused by the COVID-19 pandemic, the Centers for Medicare & Medicaid Services (“CMS”) issued a memo on March 23, 2020, prioritizing certain surveys of long-term care facilities and halting all other surveys for three weeks. Specifically, the memorandum prioritizes surveys for (1) complaints and facilities…Read More

In an effort to promote social distancing to protect Hoosier health and safety and contain COVID-19, the Indiana Department of Workforce Development (“Indiana DWD”) announced on Monday, March 23, 2020, that all of its statewide offices will be closed to the public until further notice. Individuals seeking unemployment benefits must now apply online at www.unemployment.IN.gov….Read More

Tuesday, March 24 Recap Note – ​We believe this is the most up-to-date information available at this time, but it is subject to change ​as circumstances warrant. Also, all finalized resources can be found ​on the COVID-19 ​Resource ​Center page ​of Hall Render’s website.​ Congressional Outlook Negotiations in the Senate over the third stimulus bill continued today…Read More

As the country contends with exponential growth in the number of Coronavirus Disease 2019 (“COVID-19”) cases, government agencies tasked with protecting health care programs and enforcing the law are sending strong messages to those who may commit fraud to take advantage of the current situation. The U.S. Department of Justice (“DOJ”) filed an enforcement action…Read More

As the COVID-19 pandemic continues to evolve, hospitals and health system leaders are being proactive to ensure they have the physician and advanced practice provider (“APP”) coverage needed to provide sustainable care for a growing influx of coronavirus patients. In addition, health systems are being faced with unique issues on redeployment of physicians and APPs…Read More

On Friday, March 20, 2020, the Treasury Department (“Treasury”), Internal Revenue Service (“IRS”) and the Department of Labor (“Labor”) issued a news release that offered very preliminary information about the implementation plan for the paid leave and related payroll tax credit provisions contained in the Families First Coronavirus Response Act (the “Act”), which was enacted…Read More

Earlier this week, the Second Circuit in Vierczhalek v. MedImmune, Inc.[1] affirmed the dismissal of a relator’s amended complaint, finding she was not an “original source” of new allegations that piggybacked on a public disclosure. Facts of the Case Relator Susan Vierczhalek, M.D., filed a qui tam action in 2009 alleging that drug manufacturer MedImmune,…Read More