Litigation

The U.S. Supreme Court has agreed to review the scope of the Medicare Secondary Payer Act (MSPA) as it relates to the treatment of patients with end-stage renal disease (ESRD). The case to be heard by the high court, Marietta Memorial Hospital Employee Health Benefit Plan v. DaVita, Inc.[1], originated from a suit…

On October 25, 2021, the Equal Employment Opportunity Commission (EEOC) issued a new guidance and questions and answers regarding COVID-19 issues confronting employers and employees. The EEOC’s Technical Assistance is entitled “What You Should Know about COVID-19 and the ADA, the Rehabilitation Act and Other EEO Laws.” This Technical Assistance also provides links…

The New Jersey Attorney General’s Office announced on October 12 that Diamond Institute for Infertility and Menopause, LLC, based in Millburn, NJ, will pay a $495,000 penalty for allegedly violating HIPAA and state law by failing to implement appropriate cybersecurity measures. The New Jersey Department of Law & Public Safety’s Division of Consumer Affairs investigated…

On September 17, the U.S. Department of Justice (DOJ) announced criminal charges against 138 defendants for alleged healthcare fraud schemes that resulted in $1.4 billion in losses. Those charged included 23 doctors, 19 nurses and other licensed professionals, and 96 laypeople, in 31 federal districts across the U.S.

Telehealth-related fraud accounted for about $1.1 billion…

An article in the July issue of Hospital Peer Review, “NPDB Reporting Protected by Law in Some Cases, Gray Areas Problematic,” discussed hospitals’ obligations to report doctors to the National Practitioner Data Bank (NPDB) and their protection against liability for doing so. Rivkin Radler’s Chris Kutner was quoted extensively in the article.…

Rivkin Radler partners Evan Krinick and Michael Sirignano authored an article, “Compounding the Fraud: Questionable Billing by Pharmacies,” in the July 6 issue of the New York Law Journal. The article discussed the U.S. Department of Justice’s continued concern over fraudulent claims for reimbursement to federal healthcare programs for compounded prescription drugs.

On June 16, Jeffrey Goldstein, a former Manhattan physician, was sentenced to 57 months in prison for taking $196,000 in kickbacks from Insys Therapeutics, a defunct Arizona-based opioid manufacturer. Goldstein pled guilty to conspiracy in 2019 for accepting purported “speaker fees” from Insys in 2013-15 to prescribe the company’s fentanyl spray, Subsys.

Goldstein was one…

The U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) has pursued its HIPAA Right of Access Initiative since 2019. OCR’s 19th settlement under the initiative, with The Diabetes, Endocrinology & Lipidology Center, Inc. (DELC), curiously resulted in only a $5,000 fine. The West Virginia provider treats patients who have endocrine disorders.…

On May 26, the U.S. Department of Justice (DOJ) announced criminal charges against 14 defendants in six states for participation in healthcare fraud schemes related to the COVID-19 pandemic. The coordinated takedown involved fraudulent claims for laboratory testing, telemedicine fraud, pharmacy fraud, payment of kickbacks for referrals, and alleged misappropriation of COVID-19 Provider Relief Fund…

The U.S. Department of Justice recently announced that CareCloud Health, a Florida-based developer of electronic health records software, agreed to pay $3.8 million to resolve a whistleblower’s allegations that it paid illegal kickbacks to generate sales of its products. CareCloud’s marketing referral program called the “Champions Program” allegedly violated the federal Anti-Kickback Statute (AKS) and…