Federal CPOM Ban Implications for Management Services Organizations
Last month, Senators Elizabeth Warren, Ron Wyden, and Jeff Merkley, along with Representatives Val Hoyle, Alexandria Ocasio-Cortez, and Suhas Subramanyam, introduced the Stop Corporate Takeovers of Physicians Act, the first-of-its-kind bill at the federal level to ban the corporate practice of medicine (“CPOM”) [1]. The implications this bill would have on common private equity-backed MSO- “Friendly PC” arrangements cannot be overstated. The bill enjoys support from several m
Oct 29
Looking Back on 2024: Two Litigation Events that Could Significantly Impact Healthcare’s Future
Major events of 2024 delivered heavy helpings of dispute, debate, and contention. Alongside the clashes in politics and culture,...
Nov 26, 2024
Hospital Self-Disclosure Led to $14 Million Settlement
In September 2024, the Department of Justice (“DOJ”) announced that Siouxland Surgery Center LLP, doing business as Dunes Surgical...
Oct 18, 2024
The FTC Noncompete Ban Impact to Healthcare Employment
The Federal Trade Commission (FTC) issued a final rule banning noncompete agreements nationwide in late April 2024. The rule is already facing multiple legal challenges. If it survives these challenges, it will significantly impact the healthcare industry. According to the American Medical Association (AMA), which supports the ban, between 37% and 45% of all physicians are affected by noncompetes. The AMA has taken the stand that noncompete clauses are problematic because t
May 3, 2024
Is There Really an Industry Standard for Calculating On-Call Compensation?
In February 2024, the U.S. Department of Justice (“DOJ”) joined a second whistleblower complaint against a former executive at Illinois-based Cardiac Imaging Inc. (“CII”), a mobile imaging company providing diagnostic cardiac positron emission tomography (“PET”) services. The allegations echo those addressed by the $85 million settlement reached in October 2023, which resolved alleged False Claims Act violations caused by excessive payments made to referring cardiologists by
Mar 20, 2024
$45.6 Million Settlement Related to Improper Medical Director Payments at 6 SNFs
In November 2023, Prema Thekkek, her management company, Paksn Inc. (“Paksn”), and 6 SNFs that are owned by Thekkek or managed by Paksn...
Nov 28, 2023
Notable OIG Advisory Opinion: Favorable Toward Employed Physician Bonuses Based on ASC Collections
In October 2023, the Department of Health and Human Services ("HHS") Office of the Inspector General (OIG) issued Advisory Opinion No. 23-07 ("AO") to a multi-specialty physician practice (the "Requestor") with 11 physician employees (the "Physicians"). The Requestor had inquired about the payment of bonuses to its employed physicians based on net profits from procedures performed by the Physicians ("Proposed Arrangement"). The Proposed Arrangement would implement a quarterly
Nov 22, 2023
4 Settlements for Alleged Improper Payments for Lease Arrangements and Medical Director Services
Four home healthcare settlements related to improper payments to physicians have been announced by the Department of Justice (“DOJ”). ...
Oct 19, 2023
Hospital Self-Disclosure Led to Settlement with DOJ
In April 2023, the Department of Justice (“DOJ”) announced that Sibley Memorial Hospital (“SMH”) and its parent company, Johns Hopkins...
Aug 31, 2023
$30 Million Settlement Resolves Allegations of AKS Violations
A nearly $30 million joint settlement was announced on May 31, 2023, by the Department of Justice (DOJ). Detroit Medical Center (DMC),...
Jun 15, 2023
FMV and the ABA’s Annual National Institute on Health Care Fraud
The American Bar Association’s 33rd Annual National Institute on Health Care Fraud was held in Chicago on May 4, 2023. Deputy Assistant...
May 23, 2023
OIG Advisory Opinion: AKS Risk Around Providing Employed NP Services at No Cost to Physicians
In December 2022, the Department of Health and Human Services (“HHS”) Office of the Inspector General (OIG) issued Advisory Opinion No....
Feb 10, 2023
Red Flags for Physicians Considering Paid Speaking Engagements
In December 2022, a Sarasota, Florida, pain management physician was sentenced to three years and six months in federal prison and ordered to forfeit $278,900 in kickbacks and bribes. According to evidence presented at trial, in less than three years, the physician’s prescriptions for Subsys, a fentanyl sublingual spray used to relieve breakthrough pain in cancer patients, had amounted to over $4.5 million in Medicare Part D payments to Insys Therapeutics, Inc., the drug’s ma
Dec 27, 2022
Improper Medical Director Payments Alleged at SNF Chain
On June 15, 2021, the United States filed a complaint under the False Claims Act against a California skilled nursing facility chain and...
Jun 30, 2021
FMV is Required for Nurse Practitioner and Other NPP Recruitment Subsidies
A less well-known, but noteworthy, exception to the Stark Law permits hospitals to grant financial subsidies to private practice physicians in support of recruitment and employment of non-physician practitioners (NPPs) in high-need fields within their communities. Available to primary care and mental health service providers, this particular NPP umbrella includes physician assistants (PAs), nurse practitioners (NPs), certified nurse-midwives, clinical social workers, and psyc
May 26, 2021
