After the United States decided to intervene, a whistleblower lawsuit under the federal false claims act was unsealed. The Amended Complaint alleges that over the period 2004 to 2010, the defendants submitted over $500 million in claims to Medicare, … [Continue reading]
US Intervenes In Whistleblower False Claims Act Lawsuit Alleging Submission of More Than $500 Million in Improper Claims
July 19, 2013 By
After Ten Years of Litigation Physician Awarded $100,000 in Damages
July 15, 2013 By
On December 19, 2002, Dr. Granger was summarily suspended following an adverse outcome in a cardiac surgery case. His privileges were restored on January 10, 2003. Granger sued the hospital in February 2003. The case went through a nine day … [Continue reading]
Increase in Costs for Copies – But Don’t Forget HIPAA (Updated)
July 11, 2013 By
Effective July 1, 2013, medical providers in Washington may increase their charges for searching and duplicating medical records. The Department of Health (“DOH”) recently released the updated fee schedule for providers. The revised charges are as … [Continue reading]
OIG Launches New Online Submission Process for the Self-Disclosure Protocol
July 9, 2013 By
On July 8th, the Office of Inspector General (OIG) launched a new online submission process for the Self-Disclosure Protocol (SDP). The SDP allows health care providers to voluntarily identify, disclose, and resolve instances of potential fraud … [Continue reading]
Tacoma Physician Group Pays $14.5 Million To Settle Medicare Over-Billing Allegations
July 7, 2013 By
Sound Physicians, a Tacoma-based, national physician group that employs more than 700 hospitalists, paid $14.5 million to settle claims that it over-billed Medicare. Former Sound Physicians' employee Craig Thomas filed a whistleblower lawsuit under … [Continue reading]
Medicaid Disallows Reimbursement, Requires Reporting for Provider Preventable Conditions
June 28, 2013 By
Starting July 1, 2013, the Washington Medicaid program will not pay a provider for the health care costs of treating conditions that the provider could have prevented. The rule, WAC 182-502-0022, contains a long list of such conditions and adds a … [Continue reading]
Stolen Laptop Leads to Stanford’s Fifth HIPAA Breach
June 26, 2013 By
Earlier this month Stanford reported its 5th HIPAA breach since 2009. This is Stanford's third largest breach, affecting nearly 13,000 patients. A broken laptop containing protected health information of pediatric patients was stolen from a … [Continue reading]
Deadline for Avoiding the eRx Payment Adjustment Approaching at End of the Month
June 18, 2013 By
The June 30, 2013 deadline to participate in the Electronic Prescribing Incentive Program (“eRx”) and avoid the 2014 eRx payment adjustment is fast approaching. Eligible Professionals (“EP’) looking to avoid the 2% payment adjustment in 2014 … [Continue reading]
EHR Incentive Program Meaningful Use Stage 1 Updated
June 11, 2013 By
CMS has recently published a tip sheet consolidating for eligible professionals and hospitals the revisions made to the Stage 1 meaningful use measures that are effective in 2013. These changes modify the following meaningful use … [Continue reading]
Urology Group Challenge to Stark Regulations Is Too Little Too Late
June 10, 2013 By
A recent federal district court decision granted summary judgment to the government in a lawsuit by a urology group challenging the 2008 changes in Stark regulations affecting “under arrangement” services for hospital patients. The decision … [Continue reading]
