In this election season, both presidential candidates offer plans to deal with the rising cost of providing health care services, the President’s “Obamacare” by increasing the number of insured individuals through Health Insurance Exchanges, and reducing costs for a continuum of services through Accountable Care Organizations; and Governor Romney by a consumer-driven approach through Medicare vouchers, tax credits, and Health
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Medicare Issues in Bankruptcies
In its August 2012 issue, the American Bankruptcy Institute Journal published Medicare Issues in Bankruptcies by Ted Berkowitz and Veronique Urban of Farrell Fritz.
The takeaways:
-Health care entities contemplating a bankruptcy filing should carefully consider the effects that the filing will have on their Medicare arrangements;
-Health care debtors should be aware that any automatic stay will likely not
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Hospital-Physician Contracts Lead to Stark Violation
The recent decision in United States ex. rel. Drakeford v. Tuomey Healthcare Sys. Inc., No. 10-1819 (4th Cir. Mar. 30, 2012) provides a sobering reminder that hospital-physician contracts should be drafted carefully in order to avoid containing any provisions that could inadvertently result in Stark law liability.
Subject to certain limited exceptions, the federal Stark Law prohibits a physician
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False Claims Act Settlement Requires Admission of Conduct
The U.S. Attorney’s Office for the Southern District of New York recently announced the settlement of a health care False Claims Act case against Beth Israel Medical Center for fraudulently inflating its fees for services provided to Medicare patients in order to obtain larger “outlier payments.” Beth Israel agreed to pay over $13 million to settle the Government’s claims for
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Medicare Publishes 60-day Repayment Rule
The 2010 Patient Protection and Affordable Care Act (“PPACA”) imposed an obligation upon Medicare providers, including physicians, hospitals, nursing homes and home health agencies, to report and return any overpayments they receive within 60 days of identification of the overpayment. Failure to do so could result in substantial penalties to the provider under the False Claims Act even if the
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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 on an annual basis. The
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