RECENT HEALTH LAW NEWS

An article in the March 20 issue of the Report on Medicare Compliance, “New NYS Compliance-Program Requirements May Be Useful Everywhere as a ‘Fresh Look,’” discussed the final compliance and self-disclosure regulations released by the New York Office of Medicaid Inspector General (OMIG) on December 28. Rivkin Radler’s Bob Hussar was quoted…
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Ullman breaks down FTC’s recent Health Products Compliance Guidance
March 23, 2023 | Rivkin Rounds Staff | Legislation and Public Policy | Medical Devices and Wearables

Rivkin Radler’s Marc Ullman spoke with Stephen Daniells, Editor-in-Chief of Nutraingredients-USA, for the March 22 article, “Ullman breaks down FTC’s recent health products compliance guidance.” Sign up to receive Rivkin Rounds at www.RivkinRounds.com. Continue Reading
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The taxman cometh: File wisely, secure the most from practice deductions
March 23, 2023 | Rivkin Rounds Staff | Tax/IRS

A March 13 article in Part B News, “The taxman cometh: File wisely, secure the most from practice deductions,” discussed tax tips for medical practices. Rivkin Radler’s Lou Vlahos was quoted in the article. Lou discussed, among other topics, the common advice to practice owners that they should consider employing family…
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The Prohibition against the Corporate Practice of Medicine: Alive and Well and on the Government’s Radar
March 23, 2023 | Jeffrey Ehrhardt | Legislation and Public Policy | Litigation

A law in New York Gov. Kathy Hochul’s proposed budget aimed at regulating “large physician practices being managed by entities that are investor-backed” has been dropped from the State Senate and Assembly proposed budgets (S4007B/A3007B). Subject to final budget negotiations, the proposed law appears unlikely to be enacted in the…
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Westchester DA Brings Charges for Unlicensed Dental Practice
March 23, 2023 | Sean Simensky | Dentistry | Fraud and Abuse | Litigation

The Westchester District Attorney’s office announced on March 17 that it has charged Cesar Masso, a 78-year-old Queens resident, with illegally practicing dentistry without a license. Masso operated a dental practice in White Plains under the name East Post Dental, performing professional services including extractions, examinations, and delivering anesthetics, and…
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NY DOH Updates Adult Care Facility Admission and Retention Standards
March 10, 2023 | Mary (Connolly) Aperance | Legislation and Public Policy | Nursing Homes

The New York State Department of Health (DOH) adopted regulations effective February 22, 2023, which clarify certain resident admission and retention standards applicable to adult care facilities (ACFs), including adult homes, residences for adults, and enriched housing programs. The DOH stated that its rationale for the changes is to ensure that…
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Avoid Common Mistakes in Malpractice Cases
March 10, 2023 | Rivkin Rounds Staff | Litigation

An article entitled “Avoid Common Mistakes in Malpractice Cases,” which appeared in the March 2023 issue of Healthcare Risk Management magazine, discussed how to handle an allegation of medical malpractice. Rivkin Radler’s Eric Strober was quoted extensively in the article. Eric pointed out that one of the biggest mistakes would be…
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Behavioral Health Provider Ordered to Repay $1.1 Million to NJ Medicaid Program
March 08, 2023 | Mary (Connolly) Aperance | Behavioral Health | Fraud and Abuse | Medicare and Medicaid

An audit by the New Jersey Office of the State Comptroller (OSC) found that John Gore, a licensed drug and alcohol counselor, improperly billed and received over $1 million in Medicaid payments for services provided between 2016 and 2020. Gore will be required to repay the sum of $1,160,371. Significantly,…
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Rivkin Radler’s Michael Sirignano authored an article for the March 2 issue of the New York Law Journal entitled “Healthcare Fraud Tops DOJ’s Annual False Claims Act Report – Again!” The article discussed a report issued by the U.S. Department of Justice detailing the settlements and judgments it obtained under the federal…
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In the next installment of Rivkin Radler’s Healthcare Compliance Lunch & Learn series, Rivkin Radler’s Bob Hussar will discuss the first two required elements of an Effective Compliance Program: 1. Policies and Procedures; and 2. Compliance Officer/Compliance Committee Bob is a partner in Rivkin Radler’s Compliance, Investigations & White Collar…
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A recent article in Part B News, “Be careful about upcoding; DOJ may come after it as a false claim,” discussed how the U.S. Department of Justice frequently prosecutes improper billing of CPT codes for Medicare patients. Rivkin Radler’s Jeff Kaiser was quoted in the article. “Sometimes, a provider will upcode…
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The U.S. Department of Justice announced on February 27 that the University of Pittsburgh Medical Center (UPMC), James Luketich, its Chair of Cardiothoracic Surgery, and University of Pittsburgh Physicians have agreed to pay $8.5 million to settle a qui tam suit brought by a former UPMC cardiothoracic surgeon. The suit,…
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NY Pharmacist in Oxycodone Scheme Pleads Guilty
February 23, 2023 | Eric Fader | Fraud and Abuse | Litigation | Pharmaceuticals

On February 17, Daniel Russo, a Long Island resident, pleaded guilty in federal court in Brooklyn to multiple charges in connection with illegally distributing oxycodone. Russo faces decades in federal prison when he is sentenced. Russo owned and operated Russo’s Pharmacy in Far Rockaway, Queens. From 2011 to 2014, he…
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As many of our readers are no doubt already aware, the U.S. Department of Health and Human Services announced on February 9 that the COVID-19 public health emergency (PHE) will end on May 11. The announcement gave payers, providers and states 90 days to prepare for policy changes. As discussed…
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The U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) announced on February 2 that Banner Health, a not-for-profit hospital system based in Arizona, has paid $1.25 million in order to settle alleged HIPAA violations in connection with a cyber attack. The incident occurred in 2016 when…
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On the heels of publishing their final regulations, on January 31, the New York Office of the Medicaid Inspector General (OMIG) released a variety of guidance documents addressing compliance programs; self-disclosure; and Medicaid managed care fraud, waste and abuse prevention programs. The guidance documents can be found at: Provider Compliance…
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In the next installment of Rivkin Radler’s Healthcare Compliance Lunch & Learn series, Rivkin Radler’s Bob Hussar, Ashley Algazi and Mary Connolly will present “OMIG’s FINALIZED Regulations: What You Need to Do – NOW!” On December 28, the Office of Medicaid Inspector General (OMIG) released their final compliance and self-disclosure…
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For those who just can’t get enough fraud, here are some of the “leftovers” from this edition of Fraud Week that your editor thought noteworthy. Read about a pharmacy biller’s fake copay assistance scheme: https://www.justice.gov/usao-edmi/pr/woman-convicted-billing-claims-part-65-million-pharmaceutical-coupon-fraud Genetic testing kickback schemes In TX: https://www.justice.gov/opa/pr/laboratory-owners-and-executives-charged-health-care-kickback-scheme In FL: https://www.justice.gov/opa/pr/ocenture-llc-and-carelumina-llc-settle-allegations-false-claims-unnecessary-genetic-testing And here’s a big one…
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Fraud Week: 25 Charged in Fake Nursing Diploma Scheme
January 27, 2023 | Eric Fader | Fraud and Abuse | Litigation

The U.S. Department of Justice (DOJ) announced on January 25 that 25 defendants have been indicted in Florida for their involvement in the sale of more than 7,600 fraudulent diplomas, and fake transcripts, from three now-closed Florida nursing schools. School officials participated in the scheme, in which aspiring nurses paid…
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The U.S. Attorney for the District of Connecticut recently announced that Michael Lonski, a Greenwich psychologist, pleaded guilty to healthcare fraud. Lonski admitted to billing insurers for services that were not rendered, including for deceased patients, and for dates of service when he was out of the country, or his…
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The U.S. Department of Justice (DOJ) announced on January 20 that DePuy Synthes, a subsidiary of Johnson & Johnson, agreed to pay $9.75 million to resolve allegations that it entered into a kickback scheme with an unnamed Massachusetts orthopedic surgeon. DePuy admitted that from 2013 to 2018, it gave the…
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Fraud Week: NY Gastroenterologist Gets 30 Months for Fictitious Procedures
January 24, 2023 | Eric Fader | Fraud and Abuse | Litigation | Medicare and Medicaid

The U.S. Attorney for the Eastern District of New York recently announced that Morris Barnard, a Great Neck gastroenterologist, was sentenced to 30 months in jail for billing Medicare for procedures he never performed. Between 2015 and 2020, Barnard submitted over $3 million in false claims for colonoscopy and gastroenterological…
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Don’t Post Patient Info on Social Media!
January 20, 2023 | Eric Fader | Dentistry | HIPAA | Litigation

I don’t know how to say it any more clearly. Somehow, medical and dental practices continue to get roped into responding to negative patient reviews on Yelp, Google, or elsewhere online, and posting any identifying information about a patient is a HIPAA violation. It’s protected health information (PHI), even if…
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On January 11, U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra formally renewed the federal COVID-19 public health emergency (PHE) for another 90 days. The PHE, which originally went into effect on January 31, 2020, provides important flexibilities for healthcare providers and Medicare beneficiaries and waives key reporting requirements.…
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Rivkin Radler’s Michael Sirignano authored an article for the January 5 issue of the New York Law Journal entitled “An Insurance Fraud Year in Review.” The article discussed various types of healthcare fraud for which the perpetrators were sentenced in 2022. Sign up to receive Rivkin Rounds at www.RivkinRounds.com. Continue Reading
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In the next installment of Rivkin Radler’s Healthcare Compliance Lunch & Learn series, Rivkin Radler’s Geoffrey Kaiser and Jeffrey Ehrhardt will present “A Survey of OIG’s 2022 Advisory Opinions: What They Could Mean for Your Organization.” Jeff and Jeff will: The program will take place on Thursday, January 12, from…
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FTC Issues New Business Guidance for Marketers and Sellers of Health Products
December 27, 2022 | Steven Shapiro | FDA | Legislation and Public Policy

On December 20, the Federal Trade Commission’s Bureau of Consumer Protection announced the issuance of Health Products Compliance Guidance. The revised Guidance updates the FTC’s 1998 guide, Dietary Supplements: An Advertising Guide For Industry, and is a must read for everyone involved in marketing, labeling, and creating and evaluating substantiation for dietary supplements…
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On December 23, the U.S. Congress passed the “Consolidated Appropriations Act, 2023,” the omnibus budget bill for fiscal year 2023 (HR 2617). The bill includes several provisions relating to Medicare coverage of telehealth, including extending some of the flexibilities that became effective at the beginning of the COVID-19 pandemic. The…
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The U.S. Department of Health and Human Services’ Office of Inspector General (OIG) recently issued a favorable Advisory Opinion on a hospital arrangement in which the hospital was using its employed nurse practitioners to perform services that were traditionally performed by patients’ attending physicians. Specifically, if the attending physician elected to…
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OCR Issues Warning Bulletin on Website and App Tracking Technologies
December 15, 2022 | Ashley Algazi | Cybersecurity | Electronic Health Records | HIPAA

On December 1, the U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) issued a Bulletin entitled ”Use of Online Tracking Technologies by HIPAA Covered Entities and Business Associates“ that addresses the responsibilities of HIPAA covered entities and business associates (“regulated entities”) when using online tracking technologies.…
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New Legislation Protects New Yorkers with Medical Debt
December 14, 2022 | Joseph DiBella | Hospitals | Legislation and Public Policy | Nursing Homes

New York Governor Kathy Hochul recently signed legislation designed to prevent New York hospitals and medical providers from employing certain collection practices against patients with medical debt. This protection became effective immediately upon the Governor’s signing. The legislation prohibits providers and hospitals from previous collection practices of garnishing up to…
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On November 9, the Pharmaceutical Coalition for Patient Access (PCPA) filed an action against the U.S. Department of Health and Human Services (HHS) after HHS’s Office of Inspector General (OIG) determined that a proposed patient assistance model posed more than a minimal risk of fraud, waste, and abuse under the…
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New 2023 Minimum Wages and Minimum Salaries to Take Effect
December 08, 2022 | Brian Conneely and John Diviney | Employer/Employee | Home Health | Legislation and Public Policy

Minimum hourly wages for many nonexempt employees and minimum salaries for exempt employees in New York, New Jersey and Connecticut are scheduled to increase in 2023. Employers should begin to make plans to ensure that their hourly wages for nonexempt employees, their minimum salaries for exempt employees and their wage…
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In the next installment of Rivkin Radler’s Healthcare Compliance Lunch & Learn series, Rivkin Radler’s Ben Malerba and Ben Wisher will discuss Avoiding the Pitfalls in Recent Government Enforcement. The program will cover recent audits, investigations and actions of government agencies including DOJ, MFCU, OMIG, the NY AG, and others. …
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Connecticut Doctor Pleads Guilty to Fraud and Kickbacks
November 30, 2022 | Eric Fader | Fraud and Abuse | Litigation | Medicare and Medicaid

The U.S. Attorney’s Office for the District of Connecticut announced on November 3 that Ananthakumar Thillainathan, a physician with offices in Stratford and Milford, pleaded guilty to healthcare fraud and federal kickback violations. The doctor faces up to 20 years in prison and a restitution payment of almost $1.7 million.…
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Pharmacy Not Liable for Filling Prescriptions as Ordered
November 30, 2022 | Eric Fader | Litigation | Pharmaceuticals

A Suffolk County, New York court held on November 16 that White’s Apothecary in East Hampton was not negligent when it filled a physician’s opioid and benzodiazepine prescriptions as ordered. The plaintiff had claimed that the pharmacy should be liable for filling “excessive and dangerous doses” of oxycodone and Carisoprodol,…
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Former Hospital Employees and Kingpin Indicted for HIPAA Violations
November 23, 2022 | Eric Fader | HIPAA | Hospitals | Litigation

The U.S. Department of Justice announced on November 10 that five former employees of Methodist Hospital, based in Memphis, Tennessee, were indicted by a federal grand jury for allegedly selling the names and telephone numbers of hospital patients who were involved in automobile accidents. Roderick Harvey paid them for the…
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The U.S. Department of Justice (DOJ) announced on November 16 that two pharmacy owners from Forest Hills, New York have pleaded guilty to conspiracy to commit money laundering through submission of fraudulent claims to Medicare during the COVID-19 pandemic. The co-conspirators owned over a dozen pharmacies in the New York…
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CMS Adds New Billing Code for Dental Surgeries
November 18, 2022 | Eric Fader | Dentistry | Legislation and Public Policy | Medicare and Medicaid

The American Dental Association (ADA) announced on November 15 that the Centers for Medicare & Medicaid Services (CMS) has agreed to create a new Healthcare Common Procedure Coding System (HCPCS) code G0330 for dental surgeries performed under anesthesia in hospital operating rooms. The new code resulted from an advocacy campaign…
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Artificial Intelligence Now Powers Orthodontics
November 11, 2022 | Eric Fader | Dentistry

Align Technology, the manufacturer of the Invisalign system of orthodontic braces, recently announced the release of an improved artificial intelligence-assisted smartphone app that can direct an Invisalign wearer when to advance to his or her next set of aligners. The company’s “Virtual Care AI-assisted Remote Monitoring Solution” helps patients take…
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The Triple Threat of Workers’ Compensation Fraud
November 04, 2022 | Rivkin Rounds Staff | Fraud and Abuse | Litigation | Medicare and Medicaid

Rivkin Radler’s Michael Sirignano authored an article for the November 3 issue of the New York Law Journal entitled “The Triple Threat of Workers’ Compensation Fraud.” Although the article wasn’t in time for Rivkin Rounds’ recent Fraud Week, it discussed some recent attempts by healthcare providers to game the workers’…
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New Employment Laws and Regulations Regarding Marijuana in the Workplace
October 31, 2022 | Rivkin Rounds Staff | Cannabis | Employer/Employee | Legislation and Public Policy

In the next installment of Rivkin Radler’s Healthcare Compliance Lunch & Learn series, Rivkin Radler Partners John Diviney and Tamika Hardy will discuss New Employment Laws and Regulations Regarding Marijuana in the Workplace. The program will cover the following topics: New state laws – New York Marijuana Regulation and Taxation…
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The Family Health Care Decisions Act’s Limitations
October 31, 2022 | Frank Izzo and Joseph Pidel | Hospitals | Legislation and Public Policy

On any given day, a medical practitioner will evaluate a patient, determine the appropriate care and then provide the required services upon the patient’s consent. However, what happens if a patient lacks capacity and is unable to consent to treatment and has no designated decision maker to take on that…
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Federal and state enforcement activity involving pharmacy fraud tops the list of categories in this edition of Rivkin Rounds’ Fraud Week. We’ll list just a sampling of cases. On October 19, the U.S. Department of Justice (DOJ) announced that Jerry May Keepers of Kingswood, Texas was sentenced to 36 months…
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Home health-related fraud and dentists behaving badly (see this week’s earlier posts) have both been notable recent trends, but the U.S. Department of Justice (DOJ) has been even busier lately cracking down on fraud involving durable medical equipment. Most recently, on October 25, DOJ announced that Daniel Canchola of Flower…
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RECENT HEALTH LAW NEWS

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