Articles and Blogs

This week, the Centers for Medicare & Medicaid Services (“CMS”) announced that it is extending the deadline for eligible hospitals and critical access hospitals (“CAHs”) to attest to meaningful use for the Medicare Electronic Health Record  Incentive Program for the 2014 reporting year from 11:59 PM EST on November 30, 2014 to 11:59 PM EST on December 31,…Read More

In September, the District Court for the Eastern District of Tennessee issued an order denying Defendants’ motions for summary judgment and permitting the government to use statistical sampling to determine liability in a False Claims Act case. The decision – a first in FCA jurisprudence – was immediately the subject of a motion for interlocutory appeal by the…Read More

On Wednesday, November 19, the House Ways and Means Subcommittee on Health released draft legislation intended to improve hospital issues in the Medicare system.  The legislation addresses Medicare’s controversial “two-midnight” rule, short inpatient stays, outpatient observation status, the RAC audit program and the appeals process. While the legislative draft is subject to change following a…Read More

Yesterday, November 20, the Department of Justice (“DOJ”) announced that the United States had recovered almost $6 billion from False Claims Act (“FCA”) litigation in 2014 – marking the first time the DOJ has recovered more than $5 billion in a single year.With these recoveries, the DOJ reached several milestones. Not only was this the largest recovery…Read More

Ways and Means Releases Draft Hospital Legislation On Wednesday, November 19, the House Ways and Means Subcommittee on Health released draft legislation intended to improve hospital issues in the Medicare system.  The legislation addresses Medicare’s controversial “two-midnight” rule, short inpatient stays, outpatient observation status, the RAC audit program and the appeals process. While the legislative…Read More

Yesterday, November 20, the Department of Justice (“DOJ”) announced that the United States had recovered almost $6 billion from False Claims Act (“FCA”) litigation in 2014, marking the first time the DOJ has recovered more than $5 billion in a single year. With these recoveries, the DOJ reached several milestones. Not only was this the largest…Read More

Although the NLRB has been very protective of employees’ rights to comment on Facebook, sometimes employees can go too far.  In this recent case, the legal line between protected activity and unprotected activity was crossed when two employees openly planned to be insubordinate.

Lawmakers Continue Push for SGR Deal in Lame Duck More than 110 members of Congress, including the GOP Doctors Caucus, are urging House leadership to repeal and replace Medicare’s Sustainable Growth Rate (“SGR”) formula for physician payment before Congress adjourns in December. With House Ways and Means Chairman Dave Camp (R-MI) retiring at the end…Read More

Under both the Stark Law and the Anti-Kickback Statute, space lease arrangements between referring physicians and hospitals are coming under growing scrutiny as the government’s concentration on eliminating Medicare and Medicaid fraud and overpayments increases. Safe harbors and exceptions with respect to lease arrangements exist under both statutes with one of the requirements being that…Read More

Relator Thulin was a pharmacist in Idaho working for Shopko, a Wisconsin company. He filed an FCA claim alleging Shopko defrauded Medicaid by failing to pass along private insurance plan prices to Medicaid for dual-eligible patients. The court rejected Shopko’s claim, affirming the trial court’s grant of a motion to dismiss. Dual-eligible Medicaid recipients are…Read More