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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. 
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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