Whenever a hospital medical staff makes a decision that adversely affects a member’s privileges, it needs to determine whether to report the decision to the National Practitioner Data Bank (“NPDB”). Those decisions can be surprisingly complex, as a recent Federal case highlights, and may depend on the wording of the […]
Health Law Alert
OIG Annual Work Plan Adds Monthly Updates
In an effort to reflect a more “dynamic” work planning process, the OIG recently announced that, effective June 15, 2017, it went beyond its mid-year update by adding monthly updates to the annual Work Plan which are posted on the OIG’s website. See https://oig.hhs.gov/reports-and-publications/workplan/index.asp The OIG’s Work Plan is comprehensive […]
“What were you thinking?” Internal Communications as Evidence of Willful Disregard under the False Claims Act
A recent Eleventh Circuit Court of Appeals decision opens the door to a broader view of False Claims Act (“FCA”) liability. The Court’s decision in U.S. ex rel. Phalp v Lincare Holdings, Inc., issued in May 2017, looked more deeply into a Medicare supplier’s subjective state of mind than is […]
Alleged Meaningful Use Fraud Results in EHR Vendor Settlement
DOJ Settlement with eClinicalWorks In May 2017, Electronic Health Record (“EHR”) vendor eClinicalWorks settled allegations of False Claims Act and anti-kickback statute violations with the United States Department of Justice for $155 million. The government alleged that the company had misrepresented the capabilities of its software in order to be […]
False Claims Act Case Based on Real Estate Transactions Dismissed
Thomas Bingham, a real estate appraiser in the Tampa, Florida area, brought a qui tam action against BayCare Health System under the Federal False Claims Act alleging underlying violations of the Stark Law and anti-kickback statue arising out of two real estate transactions. The case is initially interesting in that […]