In a recent Southern District of New York decision, Judge Jed S. Rakoff examined the original source exception to the False Claims Act’s (“FCA”) public disclosure bar. In United States ex rel. Associates Against Outlier Fraud v. Huron Consulting Group, Inc., 2012 WL 506824 (S.D.N.Y. Feb. 16, 2012), the relator alleged that defendant Huron
Health Insurance Exchanges: Final Regulations; Legal Challenges
The U.S. Department of Health and Human Services (“HHS”) released a final rule concerning Health Insurance Exchanges (“HIE”) on March 12, 2012. The final rule will be published in the Federal Register on March 27, 2012. In late March, 2012, the U.S. Supreme Court will hear arguments concerning the constitutionality of the Patient Protection and
Hospital Wins Right to Private Action in Prompt Pay Matter
A recent decision in the Supreme Court, Kings County, has confirmed that health care providers have a private cause of action under N.Y. Insurance Law § 3224-a (the “Prompt Pay Law”).
In Maimonides Med. Ctr. v. First United Am. Life Ins. Co., 2012 NY Slip Op. 22039 (decided February 22, 2012), the Court determined
Bonus Compensation under the Stark Law
Employment arrangements between hospitals and physicians often include productivity-based compensation. This can be in the form of bonuses or adjustments to salary. A common measure of productivity is the physician’s work Relative Value Units (“RVUs”). Such productivity measures are intended to motivate newly-hired physicians and to support the fairness of compensation paid and earned.
The
New York State Medicaid Providers To Be Reviewed By CMS
Health care providers in New York that participate in Medicaid may be included in the latest cycle of the Centers for Medicare and Medicaid Services Payment Error Rate Measurement Program (“PERM”). PERM was developed in response to the Improper Payment Information Act, which requires that Federal agencies review programs that are prone to erroneous payments