Category Archives: Anti-Kickback

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OIG Rings in the New Year With New Anti-Kickback Statute Safe Harbors

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Just in time for the New Year, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services issued final regulations (Final Regulations) that revised two existing Anti-Kickback Statute safe harbors, added two regulatory safe harbors to complement existing statutory safe harbors, and created an entirely new safe harbor regarding local … Continue reading this entry

What to Know About new HHS Civil Monetary Penalties

Preparing for the Conversion to ICD-10
More than two years after first proposing regulations, the Office of Inspector General of the U.S. Department of Health and Human Services issued two final rules updating its (1) civil monetary penalty (CMP) regulations, 81 Fed. Reg. 88,334 (Dec. 7, 2016), and (2) safe harbors under the anti-kickback statute (AKS) and beneficiary inducement prohibitions, 81 … Continue reading this entry

Finance Committee Report Place Medical Device Arrangements under Increasing Scrutiny

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Hospitals and providers participating in physician-owned distributorships, or “PODs” may be at increased risk for government investigation or enforcement. A Senate Finance Committee (SFC) Report issued this month highlights the SFC’s concerns that certain POD structures may violate fraud and abuse statutes, including the Anti-Kickback Statute, Stark Law, as well as the Sunshine Act. According … Continue reading this entry

Physicians Face Increased Anti-Kickback Enforcement Focus

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It appears that the Office of Inspector General (“OIG”) now has physicians squarely in the crosshairs of one of its most powerful enforcement tools: the Anti-Kickback Statute (“AKS”). The AKS is a criminal statute with stiff penalties. It prohibits the offer or payment of anything of value with the intent to induce the referral of … Continue reading this entry

Eleventh Circuit Affirms Dismissal of Relator’s Complaint Under Amended Public Disclosure Bar

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In United States of America ex rel. Marc Osheroff v. Humana, Inc. et al., No. 13-15278 (11th Cir., Jan. 16, 2015), the Eleventh Circuit affirmed dismissal of a relator’s complaint under the public disclosure bar of the False Claims Act (FCA). The Court addressed several notable issues and provided insight as to how courts may … Continue reading this entry

Cooperative Hospital Service Organizations: A Hospital Joint Venture Option

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Cooperative Hospital Service Organizations (CHSOs) are organizations that are available for hospitals considering certain types of joint ventures with other hospitals. If the terms for their use strictly meet the regulatory requirements, CHSOs can provide both tax exemption and Antikickback Statute Safe Harbor protection for such joint ventures. CHSOs must be organized and operated on a … Continue reading this entry

Happy Holidays!

Thank you for reading, subscribing and being a part of our blog community in 2014. We hope you have a happy holiday season and a wonderful new year! – The Health Care Law Today Team We will be back with new posts the week of January 5.… Continue reading this entry

OIG Releases Fiscal 2014 Report to Congress

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The Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (DHHS) released its Semiannual Report to Congress (Report) last week summarizing health care fraud investigation activities for the second half of fiscal year 2014 and the full year’s achievements. OIG reported expected recoveries of over $4.9 billion for fiscal year … Continue reading this entry

Happy Thanksgiving!

The Health Care Law Today team is thankful for you, our readers and subscribers. Thank you all for reading, contributing to, and sharing our blog. We hope you have a safe and happy holiday. Have a great weekend!… Continue reading this entry

Outsourcing Ambulatory and Outpatient Services: What Hospitals Need to Know

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We are in the midst of a trend involving the “outsourcing” of certain outpatient and ambulatory services by hospitals and health systems. These outsourcing transactions often involve partnerships with for-profit, specialty  providers, such as imaging, ambulatory surgery, home health and hospice, physical therapy or urgent care businesses—partners with focused expertise—designed to enhance service offerings to … Continue reading this entry

Healthcare Law: What Every Provider Should Know

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Healthcare is an incredibly broad, diverse and dynamic industry. Because of the breadth in the field, providers are surrounded by a wide array of legal issues relating to: employment contracts, taxes, business structure, medical malpractice, nonprofit organization, insurance, and reimbursement to name a few. However, although the field is riddled with potential legal issues, there … Continue reading this entry

Final Regulations to Extend the Stark Exception and Anti-Kickback Statute

The Centers for Medicare & Medicaid Services (CMS) and the Department of Health and Human Services’ Office of Inspector General (OIG) finalized amendments to the Physician Self-Referral Law (Stark) and Anti-Kickback Statute regulations (the Regulations) on December 27, 2013, regarding the donation of electronic health records (EHR) systems. Among other important changes, CMS and the … Continue reading this entry