Archive
Wade Emmert
Health care company owner to pay $1 million to settle False Claims Act case
The former owner of Providence Home Health and Providence Hospice has agreed to pay $1.05 million to settle claims she knowingly and willfully paid improper kickbacks…
Cutting Out the “Middleman”? HHS Resurrects Anti-Rebate Rule for Medicare Part D
[T]he Final Rule will modify the federal health care program’s Anti-Kickback Statute (“AKS”) safe harbors in three key ways: First, it will remove safe harbor protection…
Direct Contracting Model Comes to Medicare
Under the model, healthcare providers — which CMS calls “direct contracting entities,” or DCEs — will competitively bid to manage 100% of the Medicare Part A…
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…