Gun Jumping - Don’t Act Like You’re Merged Until You Are!
Health Law Expressions
by HortySpringer
2w ago
When hospitals and health systems are pursuing a merger or affiliation, there is a natural tendency to move things along quickly. While it is ok to conduct due diligence, explore potential efficiencies and plan for what might be possible if the affiliation takes place, the parties need to refrain from acting like they are already affiliated, implementing plans or sharing competitively sensitive information such as payor contracts until the deal is done. To do so could constitute unlawful “gun jumping” in violation of federal antitrust rules, possibly subject the parties to fines and other pena ..read more
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Bigger (and Broader) is Better When It Comes to Releases
Health Law Expressions
by
2M ago
Two recent lawsuits decided by Utah courts draw attention to the importance of strong, broad release language protecting physician leaders who volunteer to participate in credentialing, peer review, and other medical staff activities. In both cases, the physicians challenging peer review activity argued that the release language set forth in the Medical Staff Bylaws should not be applied to block their claims. One aggrieved physician claimed that the release language only applied to formal review and not collegial intervention efforts. The other claimed that the release language should not app ..read more
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Urine Trouble
Health Law Expressions
by Henry Casale and Hala Mouzaffar
1y ago
The Kickback Chronicles, Episode 12 On this week’s episode, HortySpringer attorneys Henry Casale and Hala Mouzaffar look at a North Carolina Medicaid fraud scheme in which Medicaid recipients were required to submit medical unnecessary urine specimens that were billed to the North Carolina Medicaid program in order to participate in subsidized housing programs, after school programs, and mental health and other clinics.  Listen now to this episode of the “Kickback Chronicles” to see what you can learn from the misfortune of others ..read more
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The Kickback Chronicles, Episode 12: Urine Trouble
Health Law Expressions
by Henry Casale and Hala Mouzaffar
1y ago
On this week’s episode, HortySpringer attorneys Henry Casale and Hala Mouzaffar look at a North Carolina Medicaid fraud scheme in which Medicaid recipients were required to submit medical unnecessary urine specimens that were billed to the North Carolina Medicaid program in order to participate in subsidized housing programs, after school programs, and mental health and other clinics.  Listen now to this episode of the “Kickback Chronicles” to see what you can learn from the misfortune of others ..read more
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The Kickback Chronicles, Episode 11: The Pain Caused by Lying to the Feds
Health Law Expressions
by Henry Casale and Hala Mouzaffar
1y ago
On this week’s episode, HortySpringer attorneys Henry Casale and Hala Mouzaffar review the recent sentencing of two individuals connected with over prescribing Subsys, one of the drugs at the center of the opioid crisis.   Listen now to this episode of the “Kickback Chronicles” to see what you can learn from the misfortune of others ..read more
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The Kickback Chronicles, Episode 11 – The Pain Caused by Lying to the Feds
Health Law Expressions
by Henry Casale and Hala Mouzaffar
1y ago
On this week’s episode, HortySpringer attorneys Henry Casale and Hala Mouzaffar review the recent sentencing of two individuals connected with over prescribing Subsys, one of the drugs at the center of the opioid crisis.   Listen now to this episode of the “Kickback Chronicles” to see what you can learn from the misfortune of others ..read more
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Moving to a Three-Year Appointment Period – Is Now the Time?
Health Law Expressions
by Susan Lapenta and Charles Chulack
1y ago
The Joint Commission announced in mid-December that, effective immediately, hospitals could begin reappointing and renewing clinical privileges for practitioners every three years, rather than every two years.  This is nothing new for those hospitals accredited by the DNV, but with this announcement, many hospitals accredited by TJC are considering moving to a three-year appointment period.  Before making this decision, there are several factors that you should evaluate.  For example, what changes will you need to make to your Medical Staff governance documents, does state law p ..read more
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The Kickback Chronicles, Episode 9: Ain’t No Stopping It Now, Telemedicine Is Here to Stay!
Health Law Expressions
by HortySpringer
1y ago
On this week’s episode, HortySpringer attorneys Henry Casale and Hala Mouzaffar dive into the world of telemedicine. The expansion of access to telemedicine services during the COVID-19 pandemic has opened the door to a whole new type of fraud.  Join us as we take a closer look at how the OIG will be identifying and evaluating these types of cases as well as some of the most recent victims of the OIG’s crackdown on telemedicine.     Listen now to this episode of the “Kickback Chronicles” to see what you can learn from the misfortune of others ..read more
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The Kickback Chronicles, Episode 8: But For the Grace of Fraud Go I
Health Law Expressions
by Henry Casale and Hala Mouzaffar
1y ago
On this week’s episode, HortySpringer attorneys Henry Casale and Hala Mouzaffar take a closer look at a recent case involving an alleged kickback scheme between an engaged couple on separate ends of a financial relationship. In what first appeared to be a shut and close case, now remains unfinished. Learn how just two words changed everything.    Listen now to this episode of the “Kickback Chronicles” to see what you can learn from the misfortune of others ..read more
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The Kickback Chronicles, Episode 7: Oops!... She Committed Fraud Again
Health Law Expressions
by Henry Casale and Hala Mouzaffar
1y ago
On this week’s episode of The Kickback Chronicles, HortySpringer attorneys Henry Casale and Hala Mouzaffar take a closer look at a recent case involving a woman who just couldn’t get enough of the Department of Justice. While awaiting sentencing for a guilty plea of health care fraud, this week’s schemer got herself involved in yet another Medicaid billing scheme.  Listen now to this episode to see what you can learn from the misfortune of others ..read more
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