The No Surprises Act (NSA) went into effect Jan. 1, 2022, with the goal of protecting consumers from unexpected medical bills. The NSA places numerous obligations on certain healthcare providers, facilities and providers of...more
Last month, the Central District of California granted the government’s affirmative motion for partial summary judgment in U.S. v. Reliance Medical Sys., 2022 WL 524062 (C.D. Cal. Feb. 2, 2022). The Reliance Medical case...more
Looming Deadlines to Report Provider Relief Fund Period 2 Payments and COVID-19 Vaccine Claims -
The U.S. Department of Health and Human Services (HHS) reporting portal remains open only through March 31, 2022, at 11:59...more
On March 18, the Department of Justice (“DOJ”) and the Connecticut Attorney General announced that a Connecticut eye care practice and its owners had agreed to pay $192,699 to resolve allegations that the practice improperly...more
On Feb. 23, 2022, the U.S. District Court for the Eastern District of Texas granted a motion for summary judgment in favor of the Texas Medical Association and Dr. Adam Corley, striking down a portion of an interim final rule...more
On Jan. 13, 2022, the U.S. Supreme Court permitted the Centers for Medicare & Medicaid Services (CMS) to enforce its interim final rule requiring many Medicare- and Medicaid-certified providers and suppliers to vaccinate...more
HHS to Reopen Provider Relief Fund Period 1 Reporting Dec. 13-20 -
The U.S. Department of Health and Human Services (HHS) reporting portal includes a new statement appearing to give providers an additional week in...more
Hospitals and health systems continue to navigate an environment in flux, one consistently impacted by a significant amount of transactional and regulatory activity. During a Nov. 2, 2021, webinar titled “Key Transaction...more
As McGuireWoods noted in a Sept. 10, 2021, alert, in Sept. 20 and Sept. 23 FAQs, and in Sept. 27 and Oct. 18 alerts, President Biden’s “Path Out of the Pandemic” employee COVID-19 vaccination mandates have three main...more
HHS Grants Reporting Grace Period Until Nov. 30 for Provider Relief Fund -
The U.S. Department of Health and Human Services (HHS) recently announced a 60-day grace period to allow providers to comply with the Provider...more
In Stop Illinois Health Care Fraud, LLC v. Sayeed, No. 12-CV-09306, 2021 WL 2331338 (N.D. Ill. June 8, 2021), an Illinois district court issued an order after a recent bench trial finding that the defendants violated the...more
On July 1, 2021, Georgia’s new anti-kickback statute related to substance abuse patient brokering began prohibiting payment, or the offer of remuneration, to induce the referral of a patient to or from a substance abuse...more
Any healthcare provider that received at least $10,000 from the Provider Relief Fund (described further below) during the first half of 2020 must report on its use of those funds by Sept. 30, 2021. To facilitate these...more
Healthcare providers will have 90 days, beginning July 1, 2021, to report on funds they received in the first half of 2020 from the Public Health and Social Services Emergency Fund (Provider Relief Fund)....more
As previously discussed, on April 3, 2020, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) issued a process for inquiries to be submitted to OIG about whether administrative...more
Hosted by McGuireWoods partner Amber McGraw Walsh, chair of the firm’s nationally recognized Healthcare Department, episode five of McGuireWoods' "Healthcare Headlines" video series focuses on two key federal responses to the...more
In United States ex rel. Roshan v. E. Tex. Med. Ctr., 2020 U.S. Dist. LEXIS 252092, 2020 WL 8918651 (E.D. Tex. (Nov. 24, 2020)), a Texas federal court partially dismissed a relator’s claim alleging the defendants engaged in...more
In U.S. ex rel. Sonyika v. ApolloMD, Inc. et al., 2021 WL 1222379 (N.D. Ga. Mar. 31, 2021), a Georgia federal court allowed a relator’s Amended Complaint alleging a fraudulent scheme involving improper billing for services...more
One of the most challenging billing compliance issues ophthalmology practices encounter in coding and reimbursement is understanding when services provided on the same day as a surgical procedure are payable separately from...more
The Centers for Medicare & Medicaid Services (CMS) recently announced 2020 settlements concerning past violation or potential violations of the physician self-referral law (the Stark Law) and the number and value of such...more
After granting defendants’ motion to dismiss and dismissing plaintiff’s action with prejudice, the U.S. District Court for the Middle District of North Carolina recently denied relator’s motion to alter or amend the judgment...more
As previously discussed, on April 3, 2020, the U.S. Department of Health and Human Services Office of Inspector General (OIG) issued a process for inquiries to be submitted to OIG about whether administrative enforcement...more
Recoupment has started or will soon begin for Medicare Part A and Part B providers and suppliers who received funds in 2020 under the Medicare Accelerated and Advance Payment (AAP) Program. The Centers for Medicare & Medicaid...more
Last month, the Eleventh Circuit upheld the conviction and 11-year prison sentence of a physician-Medical Director of two substance abuse treatment centers in Florida who was convicted by a jury of participating in a...more
The U.S. Fifth Circuit recently reversed a former home health agency employee’s conviction and vacated his sentence related to three counts of healthcare fraud and abuse. Jonathan Nora was convicted by the trial court of...more