Michigan is among many states that require entities to obtain a Certificate of Need (“CON”) before performing most surgical services. While a CON is just one out of several legal and regulatory requirements that must be addressed in these situations, the process of applying for and winning approval of a CON from the Michigan Department …
Recent Case Serves as Reminder to Take Care in Structuring Sales of Physician Practices
By: Ralph Levy, Jr. Physicians Should Carefully Review Documents to Verify Information Accurately Reflects the Desired Structure of the Sale. Over the past few years, hospitals, health systems, and practice management companies have increased their efforts to acquire physician practices. Moreover, physician groups are increasingly interested in selling their practices to these interested purchasers. The …
PREVENTING OVERPAYMENTS FROM BECOMING FALSE CLAIMS
By: Andrew Sparks Overpayments to healthcare providers receiving Medicare reimbursements are at risk of civil and criminal enforcement action if not attuned to a particular reimbursement rule and diligent in compliance with the rule’s requirements. In short, the overpayment rule turns potential billing mistakes into fraud. A healthcare provider cannot keep money paid in error. …
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Health System Paid $2.4 Million Settlement After Identification in a Press Release of a Patient Who Was Engaged in Fraud
By: Kimberly Ruppel The U.S. Department of Health and Human Services Office for Civil Rights (“OCR”) announced a $2,400,000 settlement with Memorial Hermann Health System (“MHHS”) to resolve an investigation of an unauthorized disclosure of protected health information (“PHI”) as a potential violation of the Privacy Rule of the Health Insurance Portability and Accountability Act …