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Escobar case limits False Claims Act liability for providers

Christina Randolph July 18, 2017
U.S. Supreme Court

Now that False Claims Act liability is no longer predicated on the government’s decision to identify a particular provision as a condition of payment under the Supreme Court's decision in Escobar, it will be important for health care providers to monitor how courts apply this more demanding standard of materiality. READ MORE

Final Rule on refund of Medicare overpayments: Key requirements to know

medical-billing_25257313063_o

The three key requirements that the Final Rule clarified and which all providers participating in Medicare Part A and Part B must know are: (a) when is an overpayment identified by a provider, (b) what is the required lookback period for returning overpayment, and (c) what process must be used to refund an overpayment. READ MORE

Record-breaking FCA settlements underscore importance of Stark Law compliance

Christina Randolph November 3, 2015
Health Law Checkup_default blog

With the continued focus of the government on investigating and prosecuting matters involving compliance with the Stark Law, health care systems entering into compensation arrangements with referring physicians must have robust processes in place to ensure that the compensation arrangements – at the time that they are structured and during the course of the arrangement – don’t run afoul of the Stark Law. READ MORE