Legal and practical healthcare information.
The Federal False Claims Act (“FCA”) allows private parties to bring lawsuits in the name of the federal government against defendants who allegedly “knowingly” present a false claim to the government for payment. The question for courts has been what standard should be applied to evaluate a defendant’s “knowledge.” The US Supreme Court recently clarified …
Continue reading “False Claims Act “Knowledge” Is a Subjective Standard”
Reversing previously proposed rules, the DEA recently issued new guidance allowing the continued use of telehealth when prescribing controlled substances following the end of the Covid-19 public health emergency (“PHE”). Waivers of the requirement for in-person encounters that were in place during the PHE will remain in effect for practitioner-patient telehealth relationships established as of …
Continue reading “DEA Reverses Course and Extends Telehealth Prescriptions of Controlled Substances”
The Federal False Claims Act (“FCA”) imposes civil liability for presenting a false claim to the government for payment. The Federal Anti-Kickback Statue (“AKS”) prohibits medical providers from making referrals in return for “remuneration.” In a recent decision by the Sixth Court of Appeals, the Court found that a hospital’s decision not to hire an …
Continue reading “Sixth Circuit Defines False Claims Standards”
Originally published in Healthcare Michigan, Volume 40, No. 2 Non-compete provisions are common in healthcare employment agreements. These provisions are designed to prohibit an employed or contracted provider from competing against the contracting entity by working for or starting a competing business within a certain geographic area for a set period of time. As the Michigan …
Continue reading “Proposed Rules Could Mean The End Of Non-Compete Agreements”
The current Public Health Emergency expiration deadline is this month. However, the Secretary of the Health and Human Services indicated he would provide a 60-day notice before ending the PHE in order to minimize disruptions and potential loss of government and private insurance coverage. That notice has not yet occurred. Therefore, we expect another 90 …
Continue reading “Telehealth Update: Telehealth Waivers Post-PHE and Fraud and Abuse”
The Department of Health and Human Services (“HHS”) recently announced guidelines for the application of the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) to audio-only telehealth encounters following the end of the declaration of the COVID-19 public health emergency (“PHE”). As reported here at the beginning of the Covid-19 pandemic, the HHS Office …
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As previously reported here, courts are known to “blue pencil” terms of non-compete provisions in employment agreements that do not appear to further legitimate business interests. Earlier this year, an Ohio appellate court affirmed the lower court’s modification of the scope and duration of a challenged non-compete provision found to be partially unreasonable. In Metrohealth …
Continue reading “Recent Guidance on Enforceability of Physician Non-Competes”
The Department of Justice recently released their Year in Review summary of activity by the Healthcare Fraud Unit, detailing enforcements efforts related to some of the more significant telehealth-related fraud claims in 2021. The DOJ’s litigation unit significantly expanded last year to support the Fraud Unit, resulting in material criminal prosecutions and sentences. Since 2019, …
What are non-compete agreements? In the broadest sense, non-compete agreements prohibit an employee from accepting employment by a competitor of an employer for a certain time. They are treated differently than non-solicitation agreements and confidentiality agreements. While non-compete agreements may not solely prevent competition – the agreement cannot prohibit an employee from using general knowledge …
Continue reading “Physician Non-Compete Agreements: What You Should Know”
As anticipated, the federal government has been monitoring the potential for fraud and abuse involving telehealth. Providers, lab owners, and medical equipment companies have been recent targets of investigations. The government’s attention has focused on claims related to durable medical equipment and lab testing. In September, the Department of Justice announced a nationwide enforcement action …