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Huge Stark Law Hospital Settlements and Physician Culpability - The New Normal Post- Tuomey? Print E-mail
Written by MWE.com   
Thursday, 01 October 2015 00:00

After the federal government's victory against Tuomey Hospital, we have seen an increasing number of large False Claims Act (FCA) settlements with hospitals involving Stark Law allegations. Relators are even citing, as evidence of ongoing recklessness, that hospital executives have been e-mailing articles about the Tuomey case to their staff. Given the Stark Law's intricate requirements, it is unsurprising that many hospitals are presented with Stark Law compliance questions. However, the U.S. Department of Justice (DOJ) has not shown much leniency in its treatment of these cases, as shown by two recent settlements.
 
First, there is the settlement with Columbus Regional Healthcare System (Columbus) and Dr. Andrew Pippas to resolve two separate qui tams filed by a former Columbus executive, Richard Barker, in the Middle District of Georgia. Mr. Barker alleged both billing and Stark Law misconduct in his complaints. While the first complaint largely focused on allegations of improper evaluation and management upcoding and intensity-modulated radiation therapy billing, it also included some cursory allegations of improper physician financial relationships. The government declined to intervene in this case in 2013. In 2014, Mr. Barker filed a second qui tam alleging compensation to Dr. Pippas in excess of fair market value, determined in a manner that took into account the volume or value of his referrals, and paid pursuant to an employment agreement that would not have been commercially reasonable but for Dr. Pippas' referrals to Columbus. On September 4, Columbus entered into a FCA settlement to pay up to $35 million to resolve both cases.
 
The Columbus settlement contains several noteworthy characteristics...

Last Updated on Wednesday, 21 October 2015 14:53
 
OIG opinion: Free home health visits are not kickbacks Print E-mail
Written by The Health Law Offices of Anthony C. Vitale   
Tuesday, 22 September 2015 00:00

The U.S. Department of Health and Human Services Office of Inspector General recently issued  an opinion that a home healthcare provider's policy to offer free introductory visits to patients who have already chosen it as their provider does not violate the federal anti-kickback statute.

In its request for an advisory opinion, the home healthcare provider stated that patients who choose their services do so without any involvement from the home healthcare provider and with no remuneration to referral sources. Generally, patients are provided with a list of potential home healthcare agencies by their physician, hospital discharge planner or case manager.

Last Updated on Friday, 25 September 2015 19:20
 
FL ALFs Latest Target of Medicaid Fraud Investigators Print E-mail
Written by Health Law Offices of Anthony Vitale   
Thursday, 17 September 2015 00:00

Assisted Living Facilities (ALFs), and the patient placement agencies with which they work, have become the latest target of Florida's Medicaid Fraud Control Unit (MFCU) investigators.

Recently, these agencies have been conducting interviews with ALF owners, managers and marketing personnel at facilities where they suspect possible kickbacks in violations of the Florida Patient Brokering Statute and Florida Medicaid Provider Fraud StatuteFlorida Statute 409.20(2)(a)(5), punishable by five years or more in prison.

It is a violation to...

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Last Updated on Friday, 18 September 2015 16:43
 
S. Florida's Highest Paying Jobs Print E-mail
Written by FHI's Week in Review   
Tuesday, 15 September 2015 14:28

Based on research done by the SFBJ, physicians occupy five out of the six highest paying jobs in South Florida. Shaun Bevan, in a 9.11.15 post, reports that Surgeons (1), Obstetricians and Gynecologists (2), Family and General Practitioner (4), Physicians and Surgeons, All Other (5) and Internists, General (6) are top earners in the region. Chief Executives are the only non-medical profession to crack the top six, coming in at number three.

Read more in the current issue of FHI's Week in Review - 9/14/15 http://conta.cc/1LtPfuz

Last Updated on Thursday, 01 October 2015 12:41
 
Avoiding Delays in License Renewals Print E-mail
Written by FL BOM via FL Healthcare Law Firm Blog   
Thursday, 10 September 2015 00:00

It’s almost renewal time once again for many health care practitioners. If this is your renewal cycle, please note the following information provided by the Florida Board of Medicine, which can help you avoid some of the most common delays encountered with license renewals. It is important to remember the upcoming renewal is the first to have mandatory continuing medical education reporting requirements. If you have not done so, please activate your account with CE Broker and ensure that all required CME you have completed for this renewal has been uploaded.

Most of the medical practitioners renewing will be required to submit the following...

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