Hospitals Rally to Defend 340B
A consortium of hospitals from across the country has delivered a letter to Congressional leaders, urging them to preserve the federal 340B program in its present form. Neither the content nor the...
View ArticleFraud So Complicated It Takes a Neurosurgeon
Generally, when a doctor is convicted for fraud, the misdeeds are limited to a single category of fraud. Maybe the doctor charged for procedures that weren’t performed; maybe there were kickbacks for...
View ArticleHospital May Fire Employee Whose Religion Prevented Working in Abortion Unit
On June 29 a federal court dismissed a lawsuit brought against a hospital by a former employee who was fired because she refused to work in a unit where abortions were performed. In 2012 Nikita...
View ArticleOIG Approves Lease of Employees to Psych Hospital
On July 28 the Office of Inspector General (OIG) of Health & Human Services gave its blessing to a health system’s lease of employees to a related psychiatric system. Under the arrangement the...
View ArticleWhen Is a Hospital Not a Hospital?
When is a hospital not a hospital? The Fifth Circuit provided an answer in a July 29 decision in favor of a nurse seeking insurance coverage for medical treatment at a residential treatment facility....
View ArticleCourt Adopts Tough Interpretation of 60-Day Repayment Rule
New York’s Mt. Sinai Hospitals can’t seem to catch a break in its long-running battle with whistleblower Bob Kane. First, the government joined the case and wanted not just the $1,000,000 in Medicaid...
View ArticleHospital Chain Pays Heavy Price for Being Too Clever
Finding that Community Hospital Systems had been “too clever by half” in negotiating a global settlement agreement for seven whistleblower suits, a federal judge ordered the chain to pay the attorneys’...
View ArticleFree Patient Parking May Trigger False Claims Act Violation
Who knew? When you park for free at your doctor’s office, you may be a pawn in a scheme to violate the Anti-Kickback Statute, the Stark Law, and the False Claims Act. It’s enough to make you sick....
View ArticleCourt Rejects Claim that a Doctor’s Loss of Privileges is an Antitrust Injury
A federal appeals court held that a doctor who lost his privileges at a local hospital failed to establish an antitrust injury sufficient to confer standing under the Sherman Act. The United States...
View ArticleAnother Study Undercuts Physician-Owned Hospital Suspicions
Physician-owned hospitals cherry-pick well-insured patients, disfavor Medicaid and minority patients, and charge more that their nonprofit counterparts, right? Wrong, says a new study published on...
View ArticleThird Cir. Holds Hospitals May Sue Health Insurers Directly
Before September 11 the Third Circuit Court of Appeals had been out of step with its sister federal circuits when it came to the right of hospitals, physicians and other health providers to sue health...
View ArticleTwo More Hospitals Qualify for Exception to Exception to Grandfather...
The Stark Law generally prohibits physicians from referring Medicare and Medicaid patients to facilities in which they have an ownership interest. There used to be a “whole hospital exception”...
View ArticleFitbit Agrees to Sign Business Associate Agreements and Take on HIPAA Compliance
Is your Fitbit data covered by HIPAA? It depends upon where you got it (kind of). If you go to the store and pick up a Fitbit on your own, the data it generates is governed by the user agreement that...
View ArticleSuing the Hand that Feeds You
Jeffrey Jacobs alleges that Idaho’s Pocatello Hospital violated the False Claims Act because of physician recruitment contracts that were overly generous to his practice group. Jeff should know...
View ArticleA Recap of National Health IT Week
National Health IT Week wrapped up on Friday. This may have been the most eventful week in the ten year history of the event, which is organized by the Health Information Management Systems Society...
View ArticleWords Hurt: FTC Challenges Proposed Hospital Merger Using Parties’ Own...
The Federal Trade Commission (FTC or Commission) authorized action on November 6 to block the proposed merger of two hospitals located in Huntington, West Virginia. The FTC issued an administrative...
View ArticleGAO Report Says Hospital-Physician Consolidation Requires Payment Reform
Yesterday the Government Accountability Office (GAO) requested that Congress order Health & Human Services to equalize Medicare payments for the same services, whether provided in a physician...
View ArticleEighth Circuit Rejects Hospice’s Fifth Amendment Plea
But not the Fifth Amendment plea you’re thinking of. It was the takings clause, not the self-incrimination clause, that Southeast Arkansas Hospice (SAH) was pleading. And the Eighth Circuit wasn’t...
View ArticlePosting Chargemasters On-Line: Less than Meets the Eye
Michigan is just the latest state to consider legislation requiring hospitals to post their chargemasters on-line. Mich. Sen. Bill 147. These proposals have been popping up since 2013, when Time...
View ArticleDifference of Medical Opinions Doesn’t Prove One Was False
A federal court in Alabama dealt a blow to the theory that in matters of medical judgment, a false claim action can rest on expert opinion evidence alone. A patient is eligible for hospice if the...
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