A November 25 article in Part B News, “Third-party biller fraud may hook your practice, unless you protect yourself,” discussed the federal government’s recent fraud investigation of a medical biller in New York State and healthcare providers’ obligation to ensure the accuracy of their claims billing. Rivkin Radler’s Jeff Kaiser was quoted
Court: Mailing Drugs to Patients’ Homes is a Potential Stark Law Violation
A recently issued federal court opinion confirmed that certain pre-COVID era prescribing restrictions are back in place. In July 2023, a nonprofit advocacy group, Community Oncology Alliance, filed suit against the U.S. Department of Health and Human Services (HHS) regarding provisions of the Stark Law. Stark prohibits physicians from referring Medicare and Medicaid patients to
NJ Biopharma Company Settles FCA/AKS Case for $5M+
The U.S. Department of Justice announced on July 24 that Admera Health LLC, a New Jersey-based biopharmaceutical research and clinical laboratory testing company, agreed to pay $5,389,648 to resolve kickback allegations brought by two whistleblowers under the False Claims Act (FCA).
Admera provides biopharmaceutical research services for healthcare institutions and provided clinical laboratory testing services
NYS Maintains Independent Practice Authority for NPs
The New York State 2024-2025 budget includes legislation that extends until July 1, 2026 the independent practice authority for certain qualified nurse practitioners with over 3,600 practice hours.
Our prior post on this topic provides additional details on which nurse practitioners qualify to practice independently, that is, without a written practice agreement or collaborative relationship
NJ Hospital and Investors to Pay $30.6 Million to Settle FCA Claims
The U.S. Department of Justice recently announced that Silver Lake Hospital, a long-term care hospital in Newark, New Jersey, and some of its investors agreed to pay $30.6 million to settle claims that they violated the False Claims Act (FCA) and the Federal Debt Collection Procedures Act (FDCPA). The hospital allegedly overbilled Medicare by claiming
OIG Advisory Opinion Blesses Gift Card Plan
A recent Advisory Opinion (No. 23-15) from the U.S. Department of Health and Human Services’ Office of Inspector General (OIG) concluded that a healthcare consulting company’s plan to offer gift cards to physician practices in exchange for referring potential new customers to the company does not violate the federal Anti-Kickback Statute (AKS).
The consulting company
2024 Medicare Physician Fee Schedule Extends Telehealth Flexibilities
The 2024 Medicare Physician Fee Schedule final rule, released by the Centers for Medicare & Medicaid Services (CMS) earlier this month, extended certain telehealth-related flexibilities that were implemented during the early days of the COVID-19 pandemic. CMS issued a Fact Sheet summarizing the telehealth updates, as well as other important Medicare policy changes.
Until 2020
NY Physician, Wife and Staff Admit AKS Violations
The U.S. Attorney’s Office in Trenton, NJ announced on November 22 that primary care physician Yitzchok “Barry” Kurtzer of Monsey, NY, and his wife pleaded guilty to soliciting and receiving kickbacks and bribes in exchange for ordering genetic tests. Kurtzer had offices in the Scranton, PA area that his wife helped manage. Two of his
OCR Releases Resource Documents on Telehealth Risks
The U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) recently released two resource documents to help healthcare providers explain the privacy and security risks of telehealth to their patients.
The first document, entitled “Educating Patients about Privacy and Security Risks to Protected Health Information when Using Remote Communication Technologies
NY Cardiologist Settles AKS Claims for $6.5 Million
The U.S. Attorney’s Office for the Southern District of New York announced on September 18 that cardiologist Klaus Peter Rentrop and his practice, Gramercy Cardiac Diagnostic Services, P.C., agreed to pay $6.5 million to settle allegations that they violated the federal Anti-Kickback Statute and Stark Law. Rentrop admitted to paying physicians millions of dollars in