Jeffrey Jacobs alleges that Idaho’s Pocatello Hospital violated the False Claims Act because of physician recruitment contracts that were overly generous to his practice group. Jeff should know because he was recruited under one of the contracts and worked for the group for three years. According to the …
Even Brain Surgeons Make Dumb Decisions
September 28, 2015 Leave a Comment
Jay Schindler may be a neurosurgeon, but that didn’t stop him from making a bonehead move in his relations with his employer, Regional Health Physicians (RHP), in South Dakota. RHP hired Schindler to practice neurosurgery. Two years later, he developed various back-related physical issues that interfered …
Whistleblower Filed Too Early & Too Late for Share of $322M SCAN Scam Recovery
September 2, 2015 1 Comment
In a miracle of bad timing, Jim Swoben managed to lose out on a share of the $322 million recovery against SCAN health Plan by being both too early and too late in filing his qui tam action. During his days as a data encounter manager at SCAN, Jim suspected the company had been double-billing Medicare and …
Free Patient Parking May Trigger False Claims Act Violation
August 20, 2015 Leave a Comment
Who knew? When you park for free at your doctor’s office, you may be a pawn in a scheme to violate the Anti-Kickback Statute, the Stark Law, and the False Claims Act. It’s enough to make you sick. That’s one of the lessons of an August 14 federal court decision in Florida. Whistleblower Thomas …
Pay-or-Play: Think Globally
June 9, 2014 Leave a Comment
With the effective date of the “pay-or-play” employer mandate just over the horizon, employers who sponsor group health plans are well aware of the layers of complexity presented by the mandate. One of the layers that employers should be sure to unpack: how do the rules affect expatriate (expat) and …
Delays in Employer Mandate
February 18, 2014 Leave a Comment
Recently, the U.S. Department of the Treasury issued final regulations under Section 4980H of the Affordable Care Act regarding implementation of employer responsibility provisions. Of particular note for medium‑sized employers, the regulations provide for a delay in enforcing the employer mandate for employers …