On July 13, 2017, CMS issued the 2018 Proposed Rules governing the outpatient prospective payment system and ambulatory surgery prospective payment system. The Proposed Rules include a number of proposed policy changes which are subject to comment until September 11, 2017. A final rule is expected to be published on […]
Health Law Alert
Hospitals Should Use Care in Drafting Adverse Decisions on Privileges
on Thursday, 3 August 2017 in
Health Law Alert: Kristin N. Lindgren, Editor
Whenever a hospital medical staff makes a decision that adversely affects a member’s privileges, it needs to determine whether to report the decision to the National Practitioner Data Bank (“NPDB”). Those decisions can be surprisingly complex, as a recent Federal case highlights, and may depend on the wording of the […]
OIG Annual Work Plan Adds Monthly Updates
on Tuesday, 25 July 2017 in
Health Law Alert: Kristin N. Lindgren, Editor
In an effort to reflect a more “dynamic” work planning process, the OIG recently announced that, effective June 15, 2017, it went beyond its mid-year update by adding monthly updates to the annual Work Plan which are posted on the OIG’s website. See https://oig.hhs.gov/reports-and-publications/workplan/index.asp The OIG’s Work Plan is comprehensive […]
“What were you thinking?” Internal Communications as Evidence of Willful Disregard under the False Claims Act
on Tuesday, 18 July 2017 in
Health Law Alert: Kristin N. Lindgren, Editor
A recent Eleventh Circuit Court of Appeals decision opens the door to a broader view of False Claims Act (“FCA”) liability. The Court’s decision in U.S. ex rel. Phalp v Lincare Holdings, Inc., issued in May 2017, looked more deeply into a Medicare supplier’s subjective state of mind than is […]
Alleged Meaningful Use Fraud Results in EHR Vendor Settlement
on Friday, 14 July 2017 in
Health Law Alert: Kristin N. Lindgren, Editor
DOJ Settlement with eClinicalWorks In May 2017, Electronic Health Record (“EHR”) vendor eClinicalWorks settled allegations of False Claims Act and anti-kickback statute violations with the United States Department of Justice for $155 million. The government alleged that the company had misrepresented the capabilities of its software in order to be […]
