StatLaw – March 2017

OIG Announces Large 12 Year Fraud Settlement: The U.S. Attorney for the Southern District of New York on March 1, 2017 announced criminal and civil actions relating to an alleged 12 year scheme to defraud Medicare, Medicaid and other private health insurance companies of more than $50 million. The defendants named in the indictment include […]

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21st Century Cures Act Promises Greater Interoperability and Less Information-Blocking in Health Information Technology, Among Other Reforms

By: David A. Zarett, Esq. & Seth A. Nadel, Esq. Weiss Zarett Brofman Sonnenklar & Levy, P.C. On November 30, 2016, the United States House of Representatives overwhelming passed the 21st Century Cures Act (“Cures Act” or the “Act”) with broad bipartisan support. It was swiftly passed by the Senate on December 7 and signed into […]

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StatLaw – February 2017

A physician received a written notice from the Office of the Attorney General Medicaid Fraud Control Unit: The agreement the physician had entered into with a billing company is in violation of State and Federal Medicaid regulations, as it bases compensation upon a percentage of the value of claims. The notice cites an article in […]

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OIG’s New Civil Monetary Penalties Regulations Offer Insight into the Agency’s Decision-Making Process

By: David A. Zarett, Esq. and Lijia Sanchez, Esq.Weiss Zarett Brofman Sonnenklar & Levy, P.C. Effective January 6, 2017, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (HSS) issued a final rule that restructures its civil monetary penalty (CMP) regulations, shedding light on the agency’s review process in […]

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OPMC Reporter – Winter 2017

What the Doctor Ordered? Volume 6, Issue 1 PHYSICIAN SUSPENDED SIX MONTHS FOR PERFORMING UNNECESSARY PROCEDURES AND ORDERING EXCESSIVE TESTING The OPMC suspended the medical license of a physician for six months after the Hearing Committee sustained charges finding the physician guilty of committing professional misconduct by performing services not authorized by the patient or patient […]

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StatLaw – January 2017

Overtime Rule in Effect in New York State: On September 22, 2016, a U.S. District Court judge in Texas granted an Emergency Motion for Preliminary Injunction and enjoined the U.S. Department of Labor from implementing and enforcing the Federal Overtime Final Rule that was scheduled to go into effect on December 1, 2016. The Federal […]

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StatLaw – December 2016

Former Doctor Sentenced to Prison for Health Care Fraud: A former physician from Illinois who had been convicted in Federal Court of falsely certifying elderly patients for in-home care has recently been sentenced to Federal prison and required to reimburse the government for $1.5 million in losses which he was found to have caused. Banio […]

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Chaperones: Needed Now More Than Ever

In today’s uncertain and threatening times, physician assistants (PA’s) can be certain of one thing; a complaint of sexual misconduct brought by a patient is guaranteed to bring the full weight of the Office of Professional Medical Conduct down upon the PA in an immediate and unyielding fashion. Moreover, sexual misconduct is no longer exclusively […]

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Overtime-Pay Final Rule’s Salary Level Test

UPDATE: On September 22, 2016, a U.S. District Court judge in Texas granted an Emergency Motion for Preliminary Injunction and enjoined the U.S. Department of Labor from implementing and enforcing the Federal Overtime Final Rule that was scheduled to go into effect on December 1, 2016. In general, the Fair Labor Standards Act (FLSA) requires […]

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OPMC Reporter – Fall 2016

PHYSICIAN’S LICENSE SUSPENDED SIX MONTHS, PLACED ON PROBATION FOR FIVE YEARS FOR MULTIPLE ACTS OF PROFESSIONAL MISCONDUCT AND MALPRACTICE A physician was found to have practiced with negligence on more than one occasion and with gross negligence on two occasions in relation to surgeries performed on five patients. The findings included a number of deviations from […]

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StatLaw – November 2016

HHS Targets Increases in Drug Prices: The Office of the Inspector General (“OIG”) of the Health and Human Services Department (“HHS”) has released a list of items which it intends to look into, on a priority basis, in 2017. Prominently featured on this list is the goal of reducing costs for prescription drugs. The release […]

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SBME Reporter – Fall 2016

The Doctor’s Cut Volume 5, Issue 4 PHYSICIAN’S LICENSE REVOKED FOLLOWING GUILTY PLEA FOR VIOLATING THE ANTI-KICKBACK STATUTE On June 8, 2016, the respondent physician pled guilty to violation of the Anti-Kickback Statute and was subsequently sentenced to twelve (12) months in prison, a $6,000.00 fine and forfeiture of $174,000.00. The respondent admitted that, between September, […]

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StatLaw – October 2016

CMS Issues Final MACRA Rule, Expanding Exemptions and Adding Flexibility: On Friday, October 14, 2016, the Centers for Medicare and Medicaid Services (“CMS”) issued the long-awaited final rule under the Medicare Access and CHIP Reauthorization Act (“MACRA”). Now referred to as the “Quality Payment Program” (“QPP”), it still consists of two “pathways:” the Merit-based Incentive […]

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Final Section 1557 RuleNondiscrimination in Health Care Programs and Activities

Section 1557 is the nondiscrimination provision of the Affordable Care Act (ACA).  This law prohibits discrimination on the basis of race, color, national origin, sex, age or disability in health programs or activities. Section 1557 builds on long established Federal civil  rights laws and extends these nondiscrimination protections to individuals participating in: Any health program […]

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Permitted Use of Protected Health Information in Furtherance of Patient Care

A byproduct of the ever-increasing hyper-regulation of the practice of medicine is that practitioners have become more attuned to their absolute obligations towards patients’ privacy. One such obligation relates to the use and disclosure of patients’ identifying information and health records — designated “Protected Health Information”-by “covered entities” including healthcare practitioners and health plans. In […]

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