Archive
Wade Emmert
CMS final 2021 physician fee schedule rule
CMS issued the final rule for the 2021 Physician Fee Schedule and doctors will see a conversion factor of $32.41, a decrease of $3.68 from the…
Jefferson County Doctor Convicted of Health Care Fraud Violations
The fraud and abuse laws can sometimes be obtuse, but this is a clear-cut case of intentional fraud. Grigoriy T. Rodonaia, of Port Neches, Texas, was…
OIG Finalizes Rebate Rules: Removal of Safe Harbor Protections for Rebates and Creation of New Safe Harbors for Other Discounts and Service Fees
As the title implies, this final rule clarifies and amends the discount safe harbor at 42 C.F.R. § 1001.925(h) under the federal Anti-kickback statute (AKS) such…
Reimbursement Pressure in Radiation Therapy & Block Lease Arrangements
The finalized Radiation Oncology payment model and the Final CY 2021 Medicare Physician Fee Schedule (“MPFS”) have now been made public. Many in the industry will…
HHS Finalizes Highly Anticipated Final Rules Amending AKS and Stark Law Regulations, Part III: Value-Based Arrangements
A value-based arrangement is an arrangement entered into between a value-based enterprise (VBE) and one or more of its participants, or among VBE participants in the…
HHS Amends PREP Act Declaration, Including to Expand Access to COVID-19 Countermeasures Via Telehealth
On December 3, the U.S. Department of Health and Human Services (HHS) issued a fourth amendment to the Declaration under the Public Readiness and Emergency Preparedness…
New Stark and Anti-Kickback Statute Comparisons
A great resource of the a redline versions of the regulations that highlight the changes for the new revisions to Stark and the Anti-Kickback Statute. The…
OIG Issues Final Rules on Anti-Kickback Statute and the Civil Monetary Penalty
In its final rule, the OIG defined what constitutes “telehealth technologies” more broadly than in its proposed rule, but otherwise chose to track the conditions for…
Fifth Individual Charged in Health Care Kickback Conspiracy
The defendants are alleged to have conspired to pay and receive kickbacks in exchange for physicians’ orders that were used to submit claims for payment to…
Ways your Healthcare Company is Breaking the Law — Without Realizing it
According to the U.S. Department of Health & Human Services’ Breach Portal, sometimes called the “Wall of Shame,” 418 breaches of HIPAA were reported in 2019.…