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The split among the federal circuit courts over the “implied certification” of liability under the federal False Claims Act (FCA) is figuratively banging at the Supreme Court’s door.
House Subcommittee Chairman Rehberg (R-MT) unveiled his draft Labor, Health and Human Services, and Education appropriations bill that would cut $2.4 billion from 2011 funding levels, on Thursday.
ML Strategies has posted its weekly Health Care Reform Update providing timely information on implementation of the Affordable Care Act and other state and federal administrative and legislative activities related to health care reform.
In the kickoff to this year’s fall conference season, Mintz Levin’s own Thomas S. Crane will be speaking about the Anti-Kickback Statute (AKS) and current developments on Monday, September 26th at the American Health Lawyers Association (AHLA) Fraud and Compliance Forum.

OIG "tweets" fraud and abuse educational materials for physicians

September 21, 2011 | Blog | By Brian Dunphy

On September 18, the Office of Inspector General (OIG) for the Department of Health & Human Services “tweeted” about its Physician Education Training Materials, which are designed to teach physicians how to comply with the Federal fraud and abuse laws.  OIG has increasingly used Twitter to publish information that may be of interest to providers.

Texas Health Care Privacy Law

September 20, 2011 | Blog | By Daria Niewenhous

In this article "Texas Law Gives Privacy More Muscle than HIPAA", published by Law360 on September 16, 2011, Mintz Levin attorney Dianne Bourque is quoted regarding the aggressive new Texas health care privacy law.
The Center for Medicare and Medicaid Innovation has extended the deadlines for submitting  letters of intent and final applications for participation in the Bundled Payments for Care Improvement Initiative. 

Medicaid RACs: Coming Soon to a State Near You

September 15, 2011 | Blog | By Brian Dunphy, Karen Lovitch

Eliminating fraud, waste, and abuse in health care has long been a top government priority, but — as demonstrated by a series of events this week — it likely will garner even more attention as the government seeks to reduce the federal deficit by $1.5 trillion over the next ten years. Providers should closely monitor the developments.

ML Strategies Weekly Health Care Reform Update

September 14, 2011 | Blog | By Karen Lovitch

ML Strategies has posted its weekly Health Care Reform Update providing timely information on implementation of the Affordable Care Act and other state and federal administrative and legislative activities related to health care reform.
CMS has announced the publication of a proposed rule that will require HIPAA-covered laboratories to make test results available to patients no later than 180 days after the rule's effective date, which will be 60 days after publication in tomorrow's Federal Register. 

State of New York Forms Task Force Targeting Excessive Compensation at Nonprofits

September 12, 2011 | Blog | By Karen Lovitch, Nili Yolin

New York not-for-profit organizations, including hospitals, nursing homes, and managed care organizations, may need to look beyond the IRS “intermediate sanctions” regulations when setting their executives’ compensation now that Governor Andrew Cuomo’s newly formed Task Force on Not-For-Profit Entities will be reviewing these compensation levels. 

OIG Advisory Opinion Permits Donation of Telemedicine Items and Services

September 12, 2011 | Blog | By Brian Dunphy, Karen Lovitch

In a recent advisory opinion, the OIG allowed a hospital to share telemedicine resources with another hospital, in the interest of promoting new models of consultation and improving patient care by reducing unnecessary patient transfers.

A House Ways and Means Health Subcommittee hearing on September 9th showed that the debate over the meaning of the terms “consolidation” versus “integration” in the health care context is more than petty semantics. 

DOJ Charges 91 Individuals with Medicare Fraud

September 9, 2011 | Blog | By Samantha Kingsbury, Ellyn Sternfield

As some may already know, the DOJ recently charged 91 defendants from various cities and industry sectors with Medicare fraud.  

Will Congress Unite on PDUFA Reform Legislation?

September 7, 2011 | Blog | By Karen Lovitch

The Prescription Drug User Fee Act (PDUFA), which provides the framework for the regulation of pharmaceuticals and raises fees to help ensure timely and safe oversight of pharmaceuticals, is due for reauthorization, and Committees in both Chambers of Congress have already held hearings. 

Qui Tam "Seal” Windows Shrinking?

August 22, 2011 | Blog | By Daria Niewenhous, Ellyn Sternfield

When qui tam relators/whistleblowers file suit under the civil False Claims Act (FCA), they are “standing in the shoes” of the government to allege that the government has suffered damages due to fraud. 

Health Insurance Exchanges Explained: The Experts Weigh-In

August 10, 2011 | Blog | By Daria Niewenhous

The Mintz Levin Center for Health Law & Policy hosted a panel discussion entitled, “Understanding Health Insurance Exchanges: The Experts Weigh-In.” 

OIG: B-15 Exclusion of Individuals

August 7, 2011 | Blog | By Daria Niewenhous, Ellyn Sternfield

In late 2010, OIG effectively warned the health care provider community that it would begin exercising its discretionary “B-15” authority to exclude individual owners, officers and managing employees of sanctioned entities from participating in federally-funded health care programs, under Section 1128(b)(15) of the Social Security Act.
This case involved “John Doe,” a 65-year-old registered level-three sex offender. After serving time in jail, Mr. Doe was released to a homeless shelter. After sustaining serious injuries during a mugging, he was hospitalized and later discharged to a nursing home. 
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