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, …
Physician Non-Compete Agreements: What You Should Know
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 …
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Telehealth Fraud Enforcement Activity
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 …
New Safe Harbors for Telehealth
New and modified safe harbors to the Stark Law and Anti-Kickback statue allow healthcare providers and entities more flexibility to create and expand telehealth platforms in compliant fashion. On November 20, 2020, the Centers for Medicare & Medicaid Services (“CMS”) and the Office of the Inspector General (“OIG”) finalized the rules modifying the safe harbors …
New CMS “Guidance” – Clear As Mud
The Centers for Medicare and Medicaid Services recently issued new guidance for healthcare providers on documenting and reporting electronic clinical quality measures (“eCQMs”) for telehealth encounters. The new guidance was intended to provide clarity but may in fact lead to more confusion about what claims will be reimbursed if provided by telehealth methods as opposed …
Michigan Expands Telehealth Coverage
Although the current health pandemic resulted in a temporary relaxation of rules concerning remote healthcare services at both the local and federal levels, telehealth is undeniably here to stay. Michigan’s Governor Gretchen Whitmer recently signed into law a set of five bills that will expand coverage of telehealth services. Three of the new bills add …
CARES Act Expands Funding and Medicare Coverage For Telehealth Services
The Coronavirus Aid, Relief, and Economic Security (“CARES”) Act, recently passed by Congress and signed into law by President Trump, provides a number of important expansions of telehealth coverage during the public health emergency affecting those in rural areas and home health care patients and establishes significant funding for enhancement of telehealth services by updating …
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Temporary Relaxation of Supervision and Credential Requirements for Healthcare Providers
On March 29, 2020, Governor Gretchen Whitmer issued Executive Order 2020-30 temporarily suspending a number of supervision and credential requirements applicable to healthcare providers. These changes are intended to remain in effect during the public health emergency resulting from the COVID-19 pandemic and apply only to healthcare providers currently in possession of a license in …
HIPAA, the Opioid Crisis and the Role of Part 2
Updated as of December 2018 With the ever-growing opioid crisis and the President’s call to action to address that crisis particularly through the signing of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act or the SUPPORT for Patients and Communities Act, P.L. 115-271 in October, 2018 , primary …
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