Tuesday, February 17, 2015
The U.S. Department of Justice recently announced that Daiichi Sankyo Inc.,a global pharmaceutical company based in New Jersey, agreed to pay the U.S.and State Medicaid programs $39 million in a settlement agreement regardingallegations that it violated the False Claims Act by paying physicians to prescribeits drugs. Those payments constituted illegal kickbacks, according to the DOJ. […]
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Thursday, February 12, 2015
Over the last several years charitable hospitals have been keeping an eye on the requirements of Code Section 501(r), which was added by the Patient Protection and Affordable Care Act. In 2012 and 2013, the Internal Revenue Service issued proposed regulations to further define the scope of Section 501(r). Section 501(r) contains operational restrictions and […]
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Tuesday, February 3, 2015
The Internal Revenue Service (IRS) issued a private letter ruling in December2014(PLR 201451009) that has gotten the attention of professional management companies and investor-owned hospitals that have managerial interests in captive professional corporations (PCs). The IRS ruled that captive PCs may be members of an affiliated group which includes the management company or investor-owned hospital […]
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Tuesday, January 27, 2015
Physicians are increasingly leaving their private practices to become employees athospitals or to affiliate with provider groups. BNA’s Health Law Reporter recently wrote that hospital/physician alignment would be the top issue in healthcare law in 2015. The Reporter’s advisory board predicted that the increase in physician alignment would have a “ripple effect” on many legal […]
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Tuesday, January 6, 2015
Last month, the Indiana Court of Appeals upheld a $1.44 million jury verdictagainst Walgreens and a pharmacist employed by Walgreens for breaching their duties to keep customer prescription history private. In this case, the pharmacist used private customer prescription history information for her own personal purposes. Ground-breaking opinion According to Indianapolis attorney Neal F. Eggeson Jr. […]
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Tuesday, December 16, 2014
This is the last of three blog posts summarizing the fiscal year 2015 plans of theOffice of Inspector General (OIG) of the U.S. Department of Health & Human Services (HHS). The first two posts (post one, post two) covered the OIG’s plans for oversight of the Medicare and Medicaid programs. This post covers legal and […]
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Tuesday, December 9, 2014
This is the second of a three-part blog series summarizing the fiscal year 2015 work plan of the Office of Inspector General (OIG) for the U.S. Department of Health & Human Services (HHS). The first blog post described the OIG’s planned areas of focus in its oversight of Medicare Part A and Part B services […]
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Tuesday, December 2, 2014
The Office of the Inspector General (OIG) for the U.S. Department of Health & Human Services (HHS) releases an annual work plan for each fiscal year, which provides a blueprint to the OIG’s upcoming oversight and enforcement efforts. The latest plan covers fiscal year 2015 and has already gone into effect starting in October 2014. […]
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Wednesday, November 26, 2014
The Department of Health and Human Services (HHS) Office of Inspector General (OIG) recently published a proposed rule that provides new and modified regulatory safe harbors to the Anti-Kickback Statute (AKS), amends regulatory provisions related to enforcement of the Beneficiary Inducement Civil Monetary Penalty (CMP) rules, and adds a gainsharing CMP provision. The proposed rule […]
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Tuesday, November 18, 2014
Due to healthcare reform and the increased complexities of operating amedical practice, many private physicians are electing to consolidate with other practitioners or to become hospital employees. This shift makes sense as group practices tend to reduce overhead, increase negotiating leverage with private payers and increase revenues by keeping referrals within the practice group rather […]
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