The Law Doesn’t Forbid Submitting False Claims

An Eighth Circuit decision provides a reminder that the False Claims Act doesn’t forbid submitting false claims: it forbids knowingly submitting false claims.   That made all the difference in an appeal of summary judgment in favor of a physician group that, according to the relator, failed to comply with …

[Read more...]

Hold it, Doctor! Don’t Hit the Send Button!

The Joint Commission made a big splash when it issued its “Update: Texting Orders” back in the spring.  That Update rescinded the accrediting organization’s long-standing prohibition on sending physician orders via text messaging.  Practitioners were now free, the Update said, to send orders by text, …

[Read more...]

Unplanned EHR Disruptions–Common for Hospitals

The prevalence of ransomware attacks is increasing.  In fact, “[o]n average, more than 4,000 ransomware attacks have occurred daily since January 1, 2016,” according to a recent interagency government report.  Given this known threat, contingency planning by hospitals becomes even more important.  This …

[Read more...]

Same Per-Click Rule, New Rationale

On July 7 CMS issued a proposed rule reaffirming its position that the Stark Law prohibits “per-click” rent payments when the lessor is the one referring the patients to the lessee for the “click,” e.g., the test or procedure.  Say, for example, a physician leases an X-ray machine to an imaging center. …

[Read more...]

And You Thought RAC Audits Couldn’t Get Any Worse

If there’s one thing that unites the hospital industry—even the fiercest competitors—it’s hatred of audits by recovery audit contractors, or RACs.  Why?  For one thing, because RACs operate on a contingency fee basis.  They get to keep a portion of the fees they force providers to repay.  It’s as …

[Read more...]

Court Rejects End-Run of Medicare Appeals Rules

The Indiana Health Department sent a team to the Nightingale home health care and hospice group, in response to complaints.  When CMS received the team’s report, it notified Nightingale that its Medicare certification was being terminated. Nightingale filed a federal lawsuit against the Secretary of Health …

[Read more...]