News

Surgery has a long history. Even as long ago as in ancient Egypt, we have found remains showing evidence of trephination, the boring of a hole in the skull for brain surgery. More than a century of experimentation in repairing the intestines without causing sepsis eventually was solved with a…
The subtle distinctions of obstruction and witness tampering. The Mueller report’s discussion of obstruction of justice and witness tampering provides an excellent opportunity to consider how the instinct to say “don’t talk to the government” can prompt prosecution. (For those who enjoy reading legal analysis, the report has a lengthy…
The search for a solution might begin with CMS. We have a problem in America. We spend way too much money on healthcare, and the outcomes we do get are not great. I am pretty darn tired of hearing about the move from volume to value. Do you know what…
Most of those accused of wrongdoing are medical professionals. The national opioid crisis has hit the heart of Appalachia particularly hard, and federal authorities are pulling out the stops in fighting it. U.S. Attorney General William P. Barr and U.S. Department of Health and Human Services (HHS) Secretary Alex M.…
Proposed rule calls amending regulations clarifying the determination as to whether a physician qualifies as a rehabilitation physician is made by the IRF. The Centers for Medicare & Medicaid Services (CMS) has issued a proposed rule for the inpatient rehabilitation facility (IRF) prospective payment system for the fiscal year 2020.…
Could recoupments be unconstitutional? Case law is changing in favor of healthcare providers who accept Medicare and/or Medicaid. Without question, accepting Medicare and/or Medicaid payments creates a legal risk of regulatory audits. Because the reimbursements constitute tax dollars, the federal and state governments (sometimes via a contracted entity) have the…
Guidance expected to address when a provider-based location shares space with a clinic or another hospital. At the American Health Lawyers Association Medicare and Medicaid conference in March, David Wright, acting deputy director for the Center for Clinical Standards and Quality from the Centers for Medicare & Medicaid Services (CMS)…
Payments were allegedly paid under the guise of professional service agreements. MedStar Health, a health system in Maryland and Washington, D.C., and two of its hospitals have settled allegations that they violated the False Claims Act by engaging in conduct that violated the Anti-Kickback Statute. The settlement, which is not…