When Is A Hospital Employee Not An Employee?

The Federal Court of Appeals for the D.C. Circuit is wrestling with the issue of whether a locum tenens nurse working at Washington Hospital Center was an “employee” of the hospital under the hospital’s malpractice insurance policy. The issue in Interstate Fire & Casualty v. Washington Hospital …

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OIG TAKES AIM AT HOSPITAL CREDENTIALING

Does your hospital’s credentialing office feel neglected by the HHS Office of Inspector General?  Do they feel like the Maytag repair man?  If so, tell them to cheer up.  In its 2014 Work Plan, the OIG puts “Oversight of Hospital Privileging” squarely in its sights. The plan, released January 31, …

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Federal Court Orders Unscrambling of Omelet

On January 24 the U.S. District Court for Idaho ordered the unscrambling of the omelet that St. Luke’s Health System created when it acquired Saltzer Medical Group at the end of 2012.  The transaction had not required a Hart-Scott-Rodino filing and had survived an earlier request by competitors for a …

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Payments Might Generate Illegal Remuneration But OIG Won’t Impose Sanctions

With an analysis partially relying on the Sgt. Schultz defense, the Office of Inspector General's first Advisory Opinion of 2014 declines to impose sanctions under the Anti-Kickback Statute on placement fees paid for referrals to senior residential communities, even though the referrals might at some point …

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Government May Assess False Claims Act Penalties Below Statutory Minimum

A recent federal appeals court decision holds that a court may assess False Claims Act (FCA) penalties that are lower than the minimum specified by that statute. Paradoxically, that represented a win for the government and a loss for the contractor. By way of background, hospitals have long feared FCA penalties …

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One-Year Delay in Clinical Trial Number Requirement — But Not for Everyone

On January 6, 2014, the Centers for Medicare & Medicaid Services (CMS) announced a one-year delay in the requirement that an eight-digit identification number be included on all Medicare claims for services and items relating to a clinical trial. The requirement, scheduled to be effective January 1, 2014, has …

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