NYS to Publicize Physician Misconduct Investigations
January 30, 2020 | Eric D. Fader | Fraud and Abuse | Legislation and Public Policy

New York Gov. Andrew Cuomo’s 2020 State of the State Agenda includes a proposal entitled “strengthening the oversight of physicians and other medical professionals to protect patients.” The proposal includes reforms to the procedures of the state Department of Health’s Office of Professional Medical Conduct (OPMC).

The most controversial portion of the proposal would allow

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NJ Bills Preserve ACA Protections
January 28, 2020 | Eric D. Fader | Affordable Care Act | Behavioral Health | Legislation and Public Policy | Private Insurers

New Jersey Governor Phil Murphy recently signed into law a package of nine bills that will preserve for state residents many of the provisions of the Affordable Care Act (ACA) even if the ACA itself is ultimately found unconstitutional. The new laws continue a trend among Democratic states that was previously discussed on Rivkin Rounds

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OIG Issues Advisory Opinion on Discounted Training
January 21, 2020 | Ada Janocinska | Fraud and Abuse | Hospitals | Legislation and Public Policy | Medicare and Medicaid

In a recent Advisory Opinion, the U.S. Department of Health and Human Services’ Office of Inspector General (OIG) approved a proposed arrangement whereby a hospital would offer discounted training to employees of one of the hospital’s referral sources, a local fire department.

The hospital is part of a non-profit health system that offers clinical training

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Medical Equipment Co. to Pay $37.5M to Settle Kickback Claims
January 17, 2020 | Eric D. Fader | False Claims Act | Fraud and Abuse | Litigation | Medical Devices and Wearables | Medicare and Medicaid

The U. S. Department of Justice (DOJ) announced on January 15 that ResMed Corp., a San Diego-based manufacturer of durable medical equipment, will pay $37.5 million to the federal government to settle five qui tam (whistleblower) cases under the False Claims Act (FCA) alleging that ResMed paid kickbacks to DME suppliers, sleep labs and other

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DOJ Reports $3 Billion in 2019 False Claims Act Recoveries
January 14, 2020 | Eric D. Fader | False Claims Act | Fraud and Abuse | Hospitals | Litigation | Medical Devices and Wearables | Medicare and Medicaid | Pharmaceuticals

The U.S. Department of Justice (DOJ) announced last week that in the fiscal year ended September 30, 2019, it obtained more than $3 billion in total recoveries from civil cases brought under the False Claims Act (FCA). The total, a slight increase from the $2.9 billion recovered in the prior fiscal year, included both settlements

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Updated Guidance Addresses the Privacy of Student Records
January 13, 2020 | Margarita Christoforou | Behavioral Health | Electronic Health Records | HIPAA | Legislation and Public Policy

In an effort to provide further clarity to school administrators, healthcare professionals and families, the U.S. Department of Education and the Office for Civil Rights at the U.S. Department of Health and Human Services recently released updated joint guidance addressing the application of the Family Educational Rights and Privacy Act (FERPA) and the HIPAA Privacy

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Alabama Health System Reeling After Ransomware Attack
January 6, 2020 | Margarita Christoforou | Cybersecurity | Electronic Health Records | HIPAA | Hospitals | Litigation

Alabama’s DCH Health System is facing a federal lawsuit filed by some former patients who allege it was negligent in discovering and responding to a ransomware attack on its computer system. In addition to negligence, the complaint accuses DCH of invasion of privacy, breach of contract and breach of fiduciary duty, among other things. The

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The Broad Reach of the Medicare Fraud Strike Forces
January 3, 2020 | Rivkin Rounds Staff | False Claims Act | Fraud and Abuse | Litigation | Medical Devices and Wearables | Medicare and Medicaid | Pharmaceuticals | Telehealth

Rivkin Radler’s Evan Krinick authored an article for the New York Law Journal, “The Broad Reach of the Medicare Fraud Strike Forces.” The article discusses recent strike force actions in New York and New Jersey that targeted a variety of healthcare fraud schemes.


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