Articles and Blogs

AKS

Federal Court Reinforces Government’s Right to Dismiss FCA Actions over Whistleblower Objection

[10/03/19]

Posted on October 3, 2019 in Health Law News

Published by: Hall Render

The Eastern District of Texas affirmed the Government’s right to dismiss FCA actions over a whistleblower’s objections. The Court held that the Government may dismiss claims to avoid the costs of extended litigation. The United States Declined to Intervene Health Choice Alliance, LLC filed an FCA action alleging that the defendants defrauded the United... READ MORE

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Webinar Preview: Analyzing 2018 Anti-Kickback Compliance Settlements Involving Real Estate Arrangements

[09/18/19]

Posted on September 18, 2019 in Health Law News

Published by: Hall Render

The Office of the Inspector General (“OIG”) and Department of Justice (“DOJ”) often release information about compliance settlements under the Anti-Kickback Statute (“AKS”), including both the settlement value and the subject arrangement. The most recent data from 2018 shows several of these settlements arose from real estate arrangements and some involved millions of dollars... READ MORE

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Need a Lyft to See Your Doctor? Arizona Medicaid Will Now Cover Ridesharing Service

[08/06/19]

Posted on August 6, 2019 in Health Law News

Published by: Hall Render

Recently, Lyft announced that its ridesharing service is now considered a covered benefit under the Arizona Medicaid program. This announcement follows implementation of new Arizona Medicaid regulations allowing ‘”rideshare”‘ companies to enroll as non-emergency medical transportation providers. Under the policy, participating Medicaid patients can request to schedule non-emergency medical transportation to ensure access to... READ MORE

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Affordable Health Care: Patients’ Co-Pays Waived by Charitable Pediatric Clinic

[02/12/19]

Posted on February 12, 2019 in Health Law News

Published by: Hall Render

Recently, the Department of Health and Human Services Office of Inspector General (“OIG”) issued a favorable advisory opinion, Advisory Opinion 19-01, concerning a charitable pediatric clinic (the “Clinic”)’s arrangement under which the Clinic waives cost-sharing amounts for a small percentage of TRICARE and Medicare beneficiaries not covered by a state insurance program (the “Arrangement”). After... READ MORE

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Whistleblower’s Dismissal with Prejudice Not the End of the Road for Qui Tam Action

[10/30/18]

Posted on October 30, 2018 in False Claims Act Defense

Published by: Hall Render

The Fifth Circuit ruled that a whistleblower’s voluntary dismissal with prejudice cannot affect the Government’s ability to pursue related litigation. When the Government has not yet intervened, and thus is not a yet a party, a case cannot be dismissed with prejudice as to the Government by a whistleblower. Background In Vaughn, ex rel.... READ MORE

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OIG Approves Risk-Sharing Arrangement Furthering Shift Toward Value-Based Purchasing

[09/19/18]

Posted on September 19, 2018 in Health Law News

Published by: Hall Render

In the era of value-based care, health care providers and manufacturers are increasingly examining risk sharing opportunities in the treatment of patients. On September 17, the Department of Health and Human Services Office of Inspector General (“OIG”) published Advisory Opinion 18-10 whereby it approved a proposed risk sharing initiative with defined guardrails. Advisory Opinion... READ MORE

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OIG Approves Arrangement to Provide Free DME Samples

[06/06/18]

Posted on June 6, 2018 in Health Law News

Published by: Hall Render

On May 7, 2018, the Department of Health and Human Services Office of Inspector General (“OIG”) published Advisory Opinion 18-02, which approved an arrangement allowing a durable medical equipment (“DME”) distributor to provide patients with product samples at no cost to the patient. OIG stated that it would not impose sanctions against the parties... READ MORE

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New 11th Circuit Case: Fraud with Particularity

[11/03/14]

Posted on November 3, 2014 in False Claims Act Defense

Written by: David B. Honig

Last week, the 11th Circuit Court of Appeals issued its unpublished ruling in US ex rel. Mastej v. Health Management Associates, Inc. At issue was whether the relator’s Third Amended Complaint adequately pled fraud with particularity, as required by Fed.R.Civ.Pro. 9(b). Mastej was an Health Management Associate (“HMA”) executive from 2001 to February 2007. In that... READ MORE

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Safe Harbors Less Safe in Ohio

[10/17/14]

Posted on October 17, 2014 in False Claims Act Defense

Written by: David B. Honig

In a new case from the Southern District of Ohio, US_v_MillenniumRadiology, the court denied a motion to dismiss a False Claims Act suit, finding that compliance with a safe harbor could only be raised on summary judgment. The court also found that uncompensated service as a medical director could form the basis for a False Claims... READ MORE

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September 2014 FCA Update

[10/12/14]

Posted on October 12, 2014 in False Claims Act Defense

Written by: David B. Honig

Only one FCA case of interest was decided by a U.S. Circuit Court in September. In US ex rel Parikh v Brown, the Court found that a county hospital and its administrator’s participation in a “simple, brazen kickback scheme” could not be shielded by qualified immunity. The hospital and its administrator split pain center revenues with... READ MORE

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