The U.S. Court of Appeals for the Third Circuit recently issued a False Claims Act (FCA) decision calling into question productivity-based physician compensation structures under the Stark Law, in reliance on a controversial...more
10/15/2019
/ Appeals ,
Centers for Medicare & Medicaid Services (CMS) ,
Dismissals ,
False Claims Act (FCA) ,
Health Care Providers ,
Hospitals ,
Physician Compensation Arrangements ,
Physicians ,
Pleading Standards ,
Provider Payments ,
Relators ,
Reversal ,
Stark Law ,
Tuomey
In a bipartisan effort to combat the opioid crisis, H.R. 6, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act (the Act), was enacted on October 24,...more
11/16/2018
/ Controlled Substances ,
Data-Sharing ,
Department of Health and Human Services (HHS) ,
Drug & Alcohol Abuse ,
Federal Trade Commission (FTC) ,
Health Care Providers ,
Healthcare Fraud ,
Kickbacks ,
Medicaid ,
Medicaid Expansion ,
Medicare ,
Opioid ,
Pain Management ,
Pharmaceutical Industry ,
Physicians ,
Prescription Drugs ,
Public Health ,
Substance Abuse ,
Telehealth ,
Telemedicine ,
Unfair or Deceptive Trade Practices
Recent opinions by the Fifth Circuit, the Northern and Southern Districts of Texas, and the District of South Carolina offer hope to providers seeking relief from substantial monetary recoupments during the Medicare appeals...more
9/28/2018
/ Administrative Appeals ,
Administrative Law Judge (ALJ) ,
Administrative Remedies ,
Audits ,
Centers for Medicare & Medicaid Services (CMS) ,
Complaint Procedures ,
Health Care Providers ,
Injunctive Relief ,
Irreparable Harm ,
Medicare ,
Medicare Claims Appeals Process ,
Motion for Reconsideration ,
OMHA ,
Overpayment ,
Physician Medicare Reimbursements ,
Recoupment ,
Redeterminations ,
TRO
On July 17, 2018, the U.S. House of Representatives' Ways and Means Committee Subcommittee on Health ("Subcommittee") expressed its commitment to modernizing the Stark Law during a hearing in which industry and government...more
7/19/2018
/ ACOs ,
Affordable Care Act ,
Alternative Payment Models (APM) ,
Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Health Care Providers ,
Hospitals ,
Medicare Access and CHIP Reauthorization (MACRA) ,
OIG ,
Request For Information ,
Stark Law ,
Ways and Means Committee