Articles and Blogs

Jury verdicts in False Claims Act litigation are rare. Two in the same case are rarer still. On May 8, 2013, after just over four hours of deliberation, a jury in the Federal District Court of South Carolina returned a verdict for the Government, finding that the Tuomey Healthcare System violated both the Stark law…Read More

Please find below the frequently asked questions (“FAQs”) the Centers for Medicare & Medicaid Services (“CMS”) recently released concerning therapy caps and advanced beneficiary notice of noncoverage (“ABNs”).

“Daily deal” websites that offer discounted products and services are becoming more and more popular among health care providers for their ability to bring in new patients and attract attention among existing patients. It is estimated that one out of every eleven deals offered by daily deal websites are offering discounts on medical procedures, including dental…Read More

Notice Posting Rule Is Struck Down Back in August 2011, the NLRB published a rule that would require private employers to post in conspicuous places a government poster intended to notify employees of their rights under the NLRA.  Business groups challenged the rule, and the NLRB delayed the effective date several times.  Then in early 2012, courts…Read More

Recently, the Centers for Medicare & Medicaid Services (“CMS”) released the results of a study of hospice general inpatient care (“GIP”) based on an analysis of Medicare Part A hospice claims for beneficiaries who received GIP in 2011.  The intent was to identify suspected abuse of GIP in hospice inpatient facilities by hospice providers because this…Read More

The Centers for Medicare & Medicaid Services (“CMS”) recently released a Survey & Certification Letter acknowledging the change in nomenclature for the professionals working in Intermediate Care Facilities for Individuals with Intellectual Disabilities (“ICF/IID”).  Formally known as Qualified Mental Retardation Professionals (“QMRPs”), these professionals are now Qualified Intellectual Disabilities Professionals (“QIDPs”).  QIDPs are required to integrate, coordinate and monitor the treatment programs…Read More

Summary On Wednesday, May 1, 2013, the U.S. Department of Justice (“DOJ”) announced that it had reached a settlement with a two-hospital, Montana-based health system (“System”) arising from financial relationships between the System and a combination of 139 employed and independent physicians and physician groups.  Under the terms of the Settlement Agreement, the System agreed…Read More

The Centers for Medicare & Medicaid Services will publish the proposed fiscal year (“FY”) Medicare payment rate in the Federal Register later today.  Announced last week, the proposed rate includes a 2.3% market basket increase; however, a forecast error correction and other mandated adjustments will reduce the market basket increase to 1.4%.  This will still result in an estimated…Read More

False Claims Act defense attorneys have been warning government contractors, particularly Medicare and Medicaid providers, of increased risks and a reduced ability to defend against whistleblower complaints since the passage of the Fraud Enforcement Recovery Act of 2009 (“FERA”). The greatest risk comes from FERA’s addition of a new kind of reverse false claim: the…Read More