In Matter of Koch v. Sheehan, the New York Court of Appeals held that the Office of Medicaid Inspector General (“OMIG”) may remove a physician from the Medicaid program based solely on a consent order between the physician and the Bureau of Professional Medical Conduct (“BPMC”), even if BPMC does not suspend the physician’s
Alternatives to the hospital emergency room and primary care doctor’s office are opening in strip malls and other retail locations throughout the country. New York State is no exception. In an effort to provide oversight for these walk-in clinics, New York’s Public Health and Health Planning Council (PHHPC) has recommended regulations for these facilities.
In U.S. ex rel. Wolfson v. Park Avenue Medical Associates, the U.S. Attorney’s Office in the Southern District of New York entered into a $1 million False Claims Act settlement against three related companies for improperly billing Medicare for behavioral health services. The settlement agreement provided that the defendants “admit, acknowledge and accept responsibility
New York Health Law Blog contributor and Farrell Fritz associate Veronique Urban and bankruptcy partner Ted Berkowitz take a close look at the Peninsula Hospital Center bankruptcy in the September 2013 American Bankruptcy Institute Journal. Peninsula Hospital’s bankruptcy case illustrates the various elements that make health care and hospital bankruptcy cases so different from other
Earlier this month, a bill to amend the False Claims Act (“FCA”), the “Fairness in Health Care Claims, Guidance and Investigations Act,” was introduced in the House of Representatives. According to one of the bill’s sponsors, Rep. Howard Coble (R-NC), the bill’s purpose is to ensure that unintentional billing disputes are not penalized as
Is your office photocopy machine a HIPAA time-bomb? Affinity Health Plan recently learned that the answer is yes, to the tune of a $1.2 million settlement with the US Department of Health and Human Services Office for Civil Rights (OCR). Affinity is a not-for-profit managed care organization which includes one of the New York metropolitan
Senator Kemp Hannon, Chair of the New York State Senate Committee on Health (and counsel at Farrell Fritz), will be hosting a health care forum featuring a presentation by State Medicaid Director Jason Helgerson. The event will take place on Monday, August 5 from 10:00 am to noon at the Hofstra University Student Center Theatre.
The Office for Civil Rights of the US Department of Health and Human Services, in conjunction with the Workgroup for Electronic Data Interchange (“WEDI”), has announced a series of four free webinars on compliance with the latest Omnibus HIPAA/HITECH final rule, which implements significant changes in the requirements imposed upon health care organizations, providers, and
Unexpected bills to patients for out-of-network medical care have been a problem for years. Patients, their providers – both in and out-of-network – and the insurance carriers (the “payors”) have likely been involved at one time or another in the sometimes messy situation triggered by an out-of-network provider submitting a claim for charges. Payors have