The Department of Health and Human Services Office of Inspector General (OIG) released an advisory opinion (No. 15-04) today that states a proposed arrangement to provide free laboratory tests for certain patients of associated physician practices could implicate the federal anti-kickback law. An unnamed …
Attention Seniors! Check Into a Hospital and Get $100!
March 3, 2015 Leave a Comment
OIG Advisory Opinion 15-03 approves a Medigap insurer’s program that, among other things, calls for (a) network hospitals to waive the deductible for Medicare enrollees, (b) the insurer to pay the hospital network a fee each time it admits a Medicare enrollee, and (c) pay the Medicare enrollee $100 for being …
Can an Arbitrator Rule Against a Hospital for Not Violating the Anti-Kickback Statute?
February 16, 2015 Leave a Comment
Here’s a nightmare. An arbitrator rules against your hospital for failing to honor an agreement to refer Medicare patients to a home health agency. Why? Because the home health agency paid your hospital good money for the referrals, that’s why. What’s more, your state’s highest court says it …
Seventh Circuit Adopts Broad Definition of Anti-Kickback “Referral”
February 12, 2015 Leave a Comment
The federal Anti-Kickback Statute makes it a crime to give or receive anything of value in return for “referral” of a Medicare patient. But exactly what is a “referral”? That’s the issue decided by the Seventh Circuit last Tuesday in United States v. Patel. Patel is an internist with a heavy …
Government Joins Lawsuit Against Florida Doctor Alleging Fraud and Kickbacks
January 5, 2015 Leave a Comment
In a move demonstrating the government’s continued aim to combat health care fraud through its Health Care Fraud Prevention and Enforcement Action Team (HEAT), the Department of Justice announced today that the government has intervened in two qui tam lawsuits against a Florida cardiologist, Dr. Asad Qamar, and …
OIG Warns Pharma Its Copayment Coupons May Aid Crime
September 22, 2014 Leave a Comment
Brand name drugs cost a lot. So to make them more attractive, drug manufacturers issue coupons for discounts on the copayment portion of the price. They work the same as the dollar-off coupons offered by cereal manufacturers. There’s one big difference, though. If a senior citizen uses a coupon for Rice …