Articles and Blogs

Executive Summary Health care providers can significantly manage the risk posed by retained overpayments under the False Claims Act (“FCA”) by requesting counsel to conduct appropriate compliance investigations rather than performing the investigations internally.

On Monday, June 30, 2014, the U.S. Supreme Court issued a 5-4 decision in Burwell v. Hobby Lobby Stores, Inc., et al., that extends certain religious freedom protections to closely held for-profit corporations.  Specifically, the Supreme Court ruled that the Federal Government cannot impose the contraceptive mandate on closely held for-profit corporations that have religious…Read More

With the passing of the Affordable Care Act (“ACA”), False Claims Act (“FCA”) observers noted the imminent filing of cases alleging violations of the ACA’s amendments to the FCA or “reverse” false claims. Such claims are per se false claims under the FCA and arise when a government contractor or health care provider becomes aware of…Read More

The NLRB and President Obama both took a hit last week from the Supreme Court when the Justices ruled unanimously that the President’s appointment of three members of the NLRB during a recess of the Senate was unconstitutional.  We wrote about this legal challenge to presidential power previously as the case made its way through…Read More

Governor Scott Walker recently signed into law the HIPAA Harmonization – Mental Health Care Coordination Act (2013 WI Act 238, the “Act”).  The Act is intended to alleviate barriers to coordination of care for patients receiving mental health treatment by aligning aspects of Wisconsin’s mental health privacy laws with the Federal Health Insurance Portability and…Read More

Yesterday, the D.C. Circuit issued a much-anticipated decision regarding whether or not internal compliance investigations were privileged. Two recent lower court decisions had ruled that such compliance investigations were not privileged because they were for business rather than legal purposes. The D.C. Circuit disagreed and found that such compliance investigations are for legal purposes and…Read More

The Eighth Circuit affirmed that a Missouri regulatory commission’s publication of hearing testimony was “news media” sufficient to trigger the False Claims Act’s public disclosure bar. The False Claims Act includes a provision that bars FCA actions by qui tam relators if the subject matter of the action has been sufficiently disclosed by a federal…Read More

Comprehensive Post-Acute Care Reform Bill Introduced On June 26, leaders of the Senate Finance and House Ways and Means committees introduced comprehensive post-acute care legislation.  A summary of the legislation can be found here. According to a joint committee release, the legislation (H.R. 4994, S. 2553) would require data standardization to allow Medicare to compare quality…Read More

Executive Summary On June 25, 2014, the U.S. Department of Health and Human Services Office of the Inspector General (“OIG”) released a Special Fraud Alert (the “Alert”) addressing Laboratory Payments to Referring Physicians.  The Alert supplements previous guidance and is the latest in a series of advisories, dating back to 1994, discussing the fraud and…Read More

Yesterday, the American Hospital Association (“AHA”) submitted comments to CMS regarding the proposed FY 2015 inpatient prospective payment system (“PPS”) rule.  Topics addressed by AHA include: