Articles and Blogs

In light of the Supreme Court’s recent decision in Universal Health Services v. Escobar, the Seventh Circuit revisited its prior ruling in United States ex rel. Nelson v. Sanford-Brown, Ltd, a case alleging that a college receiving federal subsidies violated the False Claims Act (“FCA”) by maintaining discriminatory recruiting and retention practices. The Seventh Circuit…Read More

In United States of America and the State of Florida, ex rel. Bingham v. HCA, Inc., the employee of a medical office building management firm filed suit against a national health care system in the U.S. District Court for the Southern District of Florida. The lawsuit included allegations relating to one of the defendant’s hospitals…Read More

Health care providers subject to the Stark Law and the Anti-Kickback Statute can face significant penalties for non-compliant arrangements. In the event that a provider discovers a potentially non-compliant arrangement, it may elect to disclose the arrangement to government officials in an effort to limit its liability. Potential Stark Law violations are often disclosed to…Read More

The Eighth Circuit Court of Appeals yesterday applied the materiality standard enunciated by the Supreme Court in Universal Health Services, Inc. v. United States ex rel. Escobar to a False Claims Act (“FCA”) case alleging fraudulent inducement. In United States ex rel. Miller v. Weston Educational Inc., d/b/a Heritage College, two whistleblowers alleged Heritage College altered grade and attendance records…Read More

The Court of Appeals for the Seventh Circuit will rehear a once-dismissed Title VII sexual orientation case, possibly signaling that the Seventh Circuit will change course and read Title VII as prohibiting sexual orientation discrimination. Background Title VII prohibits employment discrimination based on race, color, religion, sex and national origin; the prohibitions apply to all…Read More

This is another article in a series discussing the complete overhaul of Part 483 to Title 42 of the Code of Federal Regulations, the Requirements for States and Long-Term Care Facilities (“Final Regulations”) by the Centers for Medicare & Medicaid Services (“CMS”). Background On September 28, 2016, CMS released a complete overhaul of Part 483…Read More

Today, the Centers for Medicare & Medicaid Services (“CMS”) published the much-anticipated Final Rule for the new Merit-Based Incentive Payment System (“MIPS”) and Advanced Alternative Payment Models (“AAPMs”) pathways to payment pursuant to the Medicare Access and CHIP Reauthorization Act of 2015 (“MACRA”). A copy of the Final Rule can be found here, and more…Read More

Review of Changes to Sections on Infection Control, Compliance and Ethics Program, Physical Environment and Training Requirements This is the fourth article in a series discussing the complete overhaul of Part 483 to Title 42 of the Code of Federal Regulations, the Requirements for States and Long-Term Care Facilities by the Centers for Medicare &…Read More

The Department of Health and Human Services Office of Inspector General (“OIG”) recently issued Advisory Opinion 16-10, which approved an arrangement between two health care districts to coordinate the education and transportation of patients with financial need (“Proposed Arrangement”). OIG stated that it would not impose sanctions against the parties for violations of the Anti-Kickback…Read More

Review of Changes to Sections on Laboratory, Radiology and Other Diagnostic Services; Dental Services; Food and Nutrition Services; Specialized Rehabilitative Services; Administration; and Quality Assurance and Performance Improvement This is the third article in a series discussing the complete overhaul of Part 483 to Title 42 of the Code of Federal Regulations, the Requirements for…Read More