A recent article in Part B News, “How to craft provider contracts that deal with board sanctions — and protect the practice,” discussed how physician practices can protect themselves against instances in which their doctors get sanctioned by the state medical board. Rivkin Radler’s Chris Kutner was quoted in the article.

Chris pointed out that

After a long quiet period, the second HIPAA settlement to be announced by the U.S. Department of Health and Human Services (HHS) in an orchestrated one-two punch was far more costly to the second violator. Lifespan Health System Affiliated Covered Entity paid $1,040,000 to HHS’s Office for Civil Rights (OCR) in June for failing to

The U.S. Department of Health and Human Services (HHS) announced on July 23 that Metropolitan Community Health Services (Metro) paid $25,000 to HHS’s Office for Civil Rights (OCR) to resolve HIPAA violations. Metro, a Federally Qualified Health Center, operates two multidisciplinary medical clinics in eastern North Carolina under the name of Agape Health Services.

Metro

The U.S. Department of Health and Human Services (HHS) and Department of Justice (DOJ) have released the 2019 annual report for their Health Care Fraud and Abuse Control Program. The government recovered almost $3.6 billion, of which about $2.5 billion was returned to the Medicare trust fund. The recoveries included judgments and settlements from fraud

Eric Fader, Jeff Kaiser, Chris Kutner, Ada Kozicz and Ben Malerba are authors of the newly released book, “The Federal Anti-Kickback Statute and Safe Harbors: A Practical Guide.”

Published by the American Bar Association, the book covers all safe harbors currently in place, as well as the interplay between the Anti-Kickback Statute (AKS) and other

The Visiting Nurse Service of New York (VNSNY) has agreed to pay $57 million to settle a whistleblower lawsuit that alleged it billed the Medicare and Medicaid programs for hundreds of millions of dollars in home care visits that were not actually provided. The lawsuit, originally filed in 2014 by a former executive of VNSNY,

On June 23, the U.S. District Court for the District of Columbia ruled against the American Hospital Association and other associations and individual hospitals that had sued the U.S. Department of Health and Human Services (HHS) to block a new price transparency rule that will take effect on January 1, 2021. The rule, which was finalized

A May 18 article in Part B News, “Assess legal risk, payer policies to head off hidden dangers of COVID-19 reopening,” discussed how medical practices should take steps to protect themselves from legal and insurance issues. Rivkin Radler’s Robert Iseman was quoted in the article, which advises medical practices that are beginning to reopen on

Rivkin Radler’s Geoffrey R. Kaiser authored an article for Law360 entitled “False Claims Act, Medical Necessity and Government Regulation of Medicine.” The full article can be found here.

On April 27, the U.S. Supreme Court ruled in favor of commercial health insurers that were seeking $12 billion under the Affordable Care Act’s risk corridor program, acknowledging that the ACA “obligated the government to pay the full amount of risk corridor payments.”

The ACA established the risk corridor program to mitigate the risks assumed