Articles and Blogs

On November 3, 2011, GlaxoSmithKline (“GSK”) announced an agreement in principle with the U.S. government for the largest settlement to date to conclude ongoing government investigations against a pharmaceutical company marketing products in the U.S.  The $3 billion settlement against GSK, the world’s fourth largest pharmaceutical company, should be finalized in 2012 and is expected…Read More

On November 1, 2011, the Centers for Medicare and Medicaid Services (CMS) issued its Calendar Year (CY) 2012 Medicare Physician Fee Schedule Final Rule (Final Rule) finalizing proposed changes that impact physician billing for services subject to a billing policy commonly known as the 3-Day Payment Window Rule (or 1-Day Payment Window Rule for certain…Read More

On October 28, 2011, the Centers for Medicare and Medicaid Services (“CMS”) published a Federal Register notice to inform the public that an application for Rural Health Clinic (“RHC”) deeming authority was submitted by the American Association for Accreditation of Ambulatory Surgery Facilities (“AAAASF”).  If approved, AAAASF, in addition to CMS, will be able to…Read More

The Centers for Medicare & Medicaid Services (“CMS”) has reevaluated the revalidation requirements in the Affordable Care Act (“ACA”), and believe the ACA allows for the extension of the revalidation period for an additional two years.  This will extend the deadline for revalidation through March of 2015.  Providers are reminded that if they have already…Read More

The National Supplier Clearinghouse (“NSC”) has recently indicated it is aware that numerous Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (“DMEPOS”) suppliers are having issues with viewing and/or submitting revalidation information through the web-based Provider Enrollment Chain Ownership System (“PECOS”). NSC has indicated that the majority of these issues are due to information discrepancies when…Read More

On November 1, 2011, the Indiana Court of Appeals issued a decision that will have an impact on all Indiana employers that have No-Fault attendance policies.  In particular, in the unemployment compensation setting, an employee will not be found to have been discharged for “just cause” (and therefore disqualified from receiving benefits) if the discharge was based…Read More

One of the most interesting recent developments is the NLRB’s focus on private employer polices that restrict employees on what they can say about their company and the people who work for it. Last month, an Administrative Law Judge for the NLRB ruled that an employer’s policies on “Courtesy,” “Unauthorized Interviews” and “Outside Inquiries Concerning…Read More

The Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program Round 2 and the national mail-order competitions are coming soon. Though the bidding schedule has not yet been released, suppliers interested in bidding should begin their preparations now to help avoid unnecessary delays or rejection of a bid application. Any supplier who plans…Read More

On October 31, 2011, the final rule (Rule) to update the Home Health Prospective Payment System (HH PPS) for Calendar Year 2012 was published in the Federal Register.  As a result of the Centers for Medicare & Medicaid Services (CMS) implementing the Rule, home health agencies (HHAs) will experience a decrease in payments of approximately…Read More

A case based upon FOIA documents may be subject to the public disclosure bar. A difference of scientific judgment does not create the basis for an FCA suit. Whistleblowers who wish to dismiss their suits after the Government refuses intervention may not hide their identity from the defendants, even if the defendant is their employer….Read More