Neurologist Dr. David Hammett will receive $4,590,000 as part of a settlement entered into by Lexington Medical Center (LMC) of West Columbia, S.C., and the federal government. Ironically, the hefty compensation comes as a result of Dr. Hammett’s blowing the whistle on LMC for over-compensating some of its …
Same Per-Click Rule, New Rationale
July 12, 2016 Leave a Comment
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. …
Aetna Wins $37.5 Million for Overbilling Scheme
April 18, 2016 Leave a Comment
It’s easy to fall into the habit of regarding self-referrals and kickbacks as strictly a matter of federal law, governed only by the federal Stark Law and Anti-Kickback Statute. But an April 13 verdict in California provides a vivid reminder that state law also has a role and that private insurers can be as …
Suing the Hand that Feeds You
October 6, 2015 Leave a Comment
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 …
Two More Hospitals Qualify for Exception to Exception to Grandfather Exception to Elimination of Whole Hospital Exception to Stark Law Prohibition
September 17, 2015 Leave a Comment
The Stark Law generally prohibits physicians from referring Medicare and Medicaid patients to facilities in which they have an ownership interest. There used to be a “whole hospital exception” excluding entire hospitals (as contrasted to departments or parts of hospitals) from the prohibition. The …