Archive
Wade Emmert
OIG Issues New Guidance Regarding Big-Box Store Gift Cards as Patient Incentives
OIG has taken the position that gift cards to “big-box” retailers are identified as impermissible “cash or cash equivalent” incentives under the Civil Monetary Penalties Law.
What Stark law, anti-kickback changes mean for value-based care at ASCs
The changes to the Anti-Kickback Statute make it easier to enter into value-based care arrangements, especially if providers take full risk. The exceptions create flexibility in…
The OCR Settles another Investigation under the HIPAA Right of Access Initiative
OCR has settled its thirteenth enforcement action under the HIPAA Right of Access Initiative, which involved a primary care physician practicing in the State of Georgia.…
Patient Recruiter Convicted in $2.8 Million Telemedicine Scheme Against Medicare
The owner of an Orlando-area telemarketing call center was convicted for his role in a kickback scheme involving expensive genetic tests and fraudulent telemedicine services that…
Hospital Price Transparency Rule in Effect
The Hospital Price Transparency Rule went into effect on January 1, 2021. The Rule requires all hospitals operating within the United States to make public a…
Proposed Changes to HIPAA Privacy Rule
HHS has proposed several important changes to the HIPAA Privacy Rule to bring it in line with HHS’s Sprint Toward Coordinated Care initiative. These proposed changes…
CMS Provides Additional Expansion Opportunities for High Medicaid Physician-Owned Hospitals
Under the Affordable Care Act’s amendments to the Stark Law, a Physician Owned Hospital (POH) cannot expand the aggregate number of operating rooms, procedure rooms or…
Texas Hospice Owner Sentenced for Fraud Scheme
A jury found Rodney Mesquias guilty last week on charges of: conspiracy to commit healthcare fraud, conspiracy to commit money laundering, conspiracy to obstruct justice, conspiracy…
Texas Heart Hospital and Subsidiary Management Company to Pay $48 Million to Settle False Claims Act Allegations Related to Alleged Kickbacks
Huge qui tam settlement where the qui tam plaintiffs will recover $13.9 million. The underlying action involves allegations that the Heart Hospital violated the Stark Law…
Federal Regulatory Compliance Issues Can Arise in State Court Matters
An interesting read regarding the use of federal regulatory compliance issues (e.g impermissible healthcare kickbacks) to support a state court tort claim. The plaintiffs sued the…