Articles and Blogs

Hope for Permanent SGR Reform in 2014 Ends On Thursday, December 4, lawmakers who back legislation that would permanently repeal and replace the Sustainable Growth Rate (“SGR”) announced that efforts to pass the measure this year have ended. According to Politico, the co-chairman of the House Republican Doctors Caucus, Rep. Phil Roe (R-TN), said there…Read More

The Indiana Court of Appeals recently issued an opinion in the case of Walgreen Co. vs Hinchy that could permanently alter the landscape for employer liability for HIPAA violations committed by employees.  Health care providers should be aware of this case and take actions to limit their exposure to this type of liability. Background In…Read More

In U.S. ex rel. Grenadyor v. Ukranian Village Pharmacy, Inc. et al., the Seventh Circuit affirmed a trial court’s dismissal  of a whistleblower’s complaint for its failure to provide sufficient specificity regarding the alleged fraud. In the opinion, Judge Posner drives a stake through the heart of a common boilerplate phrase  with clarity and precision that makes a refreshing…Read More

On December 1, the First Circuit Court of Appeals released a decision denying two Relators’ appeal of their False Claims Act action due to its failure to satisfy the Act’s first-to-file bar. Though the procedural path of the case is convoluted, the result is clear and the decision sound.

When can a hospital bar access to the premises when employees are off duty?  According to the NLRB in a recent case, it will depend on the hospital’s rule, how it is written and how much discretion the hospital has in interpreting the meaning of “hospital-related business.” Cafeteria Operator in the Hospital The hospital in…Read More

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