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Compliance Update
A Lot Can Be Learned from Tuomey Court Print E-mail
Written by Jeff Cohen | Florida Healthcare Law Firm Blog   
Tuesday, 04 August 2015 00:00

The Tuomey decision, U.S. Court of Appeals case out of South Carolina, contains important lessons for physicians, especially as it relates to (1) compensation arrangements with hospitals, (2) proper compensation arising in connection with the provision of designated health services ("DHS"), and (3) the advice of counsel defense.
 
The concept of DHS arises largely in the context of the federal Stark Law, which in pertinent part (1) forbids physicians from owning and referring to providers of DHS (e.g. PT, rehab, diagnostic imaging, home health, DME, clinical laboratory, inpatient and outpatient hospital services), (2) describes how medical practices can provide DHS to their own patients, and (3) forbids even physicians within a practice from allocating DHS profits on the basis of who ordered or referred to them.

The Tuomey case involves a whistleblower action filed against a not for profit hospital system.

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Possible delay of MU Stage 3? Print E-mail
Written by FHI's Week in Review   
Monday, 27 July 2015 00:00

WH 
Virgil Dickson, in a 7.23.15 Modern Healthcare post, reports:

The Senate Health, Education, Labor and Pensions Committee is asking to delay Stage 3 Meaningful-Use Rules, its chairman, Lamar Alexander (R-Tenn.), said during a news conference Thursday.

WIM
This will be one of several recommendations his committee will make to the Obama administration in a push to expand the use of electronic health records, which some providers say are costly and time-consuming. Sen. Alexander expressed hope that healthcare would not "go backwards on EHRs," but discussed the possibility of delaying MU3 to ensure the process goes smoothly.

Read more in the current issue of Week in Review>>

Last Updated on Tuesday, 28 July 2015 13:03
 
Federal prosecutors increasingly target individual healthcare execs in anti-fraud efforts Print E-mail
Written by Health Law Offices of Anthony Vitale   
Thursday, 16 July 2015 11:07

Last month's sentencing of the former president and CEO of OtisMed Corporation to two years in prison should serve as yet another example that federal prosecutors are not holding back when it comes to holding corporate executives accountable.
 
Charlie Chi was sentenced for intentionally distributing a medical device used in knee replacement surgery despite the fact that the Food and Drug Administration had denied the company's application for marketing clearance. In December 2014, Chi admitted to distributing, with the intent to defraud and mislead, adulterated medical devices into interstate commerce in violation of the Federal Food, Drug, and Cosmetic Act.
 
In addition to the 24-month prison sentence, Chi was ordered to serve one-year of supervised release and to pay a $75,000 fine. Prior to his own sentencing, OtisMed Corp., in September 2014, was hit with a criminal fine of $34.4 million and ordered to pay $5.16 million in criminal forfeiture.

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Last Updated on Tuesday, 18 August 2015 11:22
 
Court Upholds CMS' Prohibition on 'Under-Arrangements' Transactions, Strikes Down CMS' Prohibition on 'Per-Click' Equipment Rental Arrangements Print E-mail
Written by MWE.com   
Monday, 29 June 2015 00:00

A 2008 rule change from the Centers for Medicare and Medicaid (CMS)-which effectively prohibited referring physician-owned companies from furnishing hospital services "under arrangements"-has withstood a challenge by a urology trade association. On June 12, 2015, the U.S. Court of Appeals for the District of Columbia Circuit (D.C. Circuit) held that the 2008 rule change, which redefined an "entity furnishing designated health services" to include entities that perform the services, not just bill for them, constituted a reasonable construction of the Stark Law and was entitled to deference. The appellate court, however, held that CMS' prohibition on "per-click" equipment rental arrangements lacked a rational basis in light of the agency's "tortured reading" of a relevant conference report, which, the court noted, was "the stuff of caprice." Accordingly, the court struck down CMS' 2008 prohibition on per-click equipment rental arrangements involving referring physician-owned equipment leasing companies.

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Governing Boards in Healthcare: Making Compliance a Priority Print E-mail
Written by Jackie Bain | Florida Healthcare Law Firm Blog   
Tuesday, 16 June 2015 00:00

Does your healthcare entity have a governing Board? How involved is that Board in overseeing your business? Would your Board members be able to respond to questions about your business' compliance-related activities? 

Recently, the Office of the Inspector General ("OIG"), in conjunction with a host of non-profit healthcare associations, released guidance on achieving compliance for healthcare governing boards. The guidance is not based on abstract principals of compliance, instead it points to applicable federal law, OIG guidance, case law, and sentencing guidelines.

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