False Claims and Anti-Kickback Defendants Should Insist on Discovery from the Whistleblower/Relator

One arrow in the quiver for healthcare providers sued for violations of false claims and anti-kickback statutes is pressing for discovery from the whistleblower/relator, including a deposition of the relator.  The failure of the whistleblower to comply with the discovery obligations could result in meaningful sanctions, including dismissal.

In Guthrie v. A Plus Home Health Care, Inc. et al, 0:12-cv-60629-WPD (S.D. FL), the relator, William Guthrie, sued a home health care provider, its seven doctors, and their spouses, alleging that the doctors and their spouses implemented a fraudulent scheme of compensation and referral payments resulting in violations of the False Claims Act, the Stark Act, and the federal Anti-Kickback Statute. Continue reading “False Claims and Anti-Kickback Defendants Should Insist on Discovery from the Whistleblower/Relator”

Duane Morris Special Counsel Michael E. Clark to Present on “The Physician and Attorney Relationship in a Fraud Audit”

Duane Morris special counsel Michael E. Clark will be speaking on “The Physician and Attorney Relationship in a Fraud Audit: Working Through Related Ethical Issues,” during the Physicians Legal Issues Conference presented by the American Bar Association Health Law Section in conjunction with the Chicago Medical Society and the American College of Physician Executives. Mr. Clark’s presentation will be on Friday, June 13, 2014 from 8:00 a.m. until 9:15 a.m. at the Palmer House Hilton in Chicago.

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Duane Morris’ Michael E. Clark Quoted in Modern Healthcare

Duane Morris special counsel Michael E. Clark of the firm’s Houston office, is quoted in “AHA Lawsuit over ‘Two-Midnight’ Rule Called Uphill Battle,” which appeared in Modern Healthcare on April 15, 2014.

No matter how strong their legal arguments, hospitals will have a tough time convincing judges to overturn Medicare’s controversial new rules on classifying inpatients, some legal experts say.

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Mobile Medical Apps Guidance

Mobile health application developers, manufacturers, investors, healthcare providers and others received welcome news late last month when the U.S. Food and Drug Administration published its long-awaited final guidance on mobile medical applications under the Federal Food, Drug, and Cosmetic Act. It is vital for any app developer to understand whether the guidance applies to their product from the initial design stage. Those who are already marketing software and apps that involve healthcare should also review the guidance with care to try to determine how FDA’s new regime impacts both business plans and continuing operations.

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HIPAA Marketing and Sale Provisions: Legal Potholes for Providers, Payors, Advertisers, Data Aggregators, Market Researchers and Others

The 2013 HIPAA Amendments directly apply to healthcare providers, plans and clearinghouses as “covered entities,” as well as their subcontractors and vendors as “business associates” (including their downstream subcontractors and agents). However, it is not just covered entities and business associates that need to understand the 2013 Amendments. Advertisers, data aggregators, market researchers and others that want access to PHI, even data that appear to be de-identified, will be impacted.

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What the New HIPAA Rules Say About Health Information Technology for Users, Developers and Investors

HIPAA-covered entities and many of their vendors—among them are HIO and EHR consultants, data analytic firms, data transmission facilitators, software vendors and device vendors—rely on health information technology (HIT) to accomplish their purposes. Large data companies, small entrepreneurs and investors are participating in the growth of HIT.

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New HIPAA Rules Regarding Genetic Information Affect Employers, Group Health Plans, Health Insurers and Healthcare Providers

Because HIPAA includes employer-sponsored group health plans under the definition of insurers, employers that sponsor plans are also affected by the GINA amendments to the HIPAA Privacy Rule (“the GINA amendments”). In addition, the GINA amendments will have applicability beyond the insurance industry because they draw distinctions between permissible and impermissible uses of “genetic information” in connection with the diagnosis of a medical condition. Click here to read more about how the new HIPAA rules regarding genetic information affect employers, group health plans, health insurers and healthcare providers.

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Duane Morris Partner Susan Kayser Is Quoted in McKnight’s Long-Term Care News & Assisted Living Article

Duane Morris partner Susan Kayser is quoted in the McKnight’s Long-Term Care News & Assisted Living article, “Falsified Records Mean Legal Woes for Adminstrator, Aide,” in which she discusses the alteration of records in a long-term care setting, in light of two recent cases that landed a nursing home administrator and a nurse aide in legal hot water.

Click here to read the article and Susan’s comments on this long-term care and assisted living issue.

Some Thoughts on HIPAA

A few thoughts on HIPAA

Real case scenario. A health care provider’s car gets broken into and private health information (“PHI”) is stolen, along with other items. Next steps? Once the provider determines that a breach of unsecured PHI has occurred (an incidental disclosure of PHI does not constitute a breach), the provider should perform a risk assessment to determine whether the event poses a significant risk of financial, reputational or other harm to the patient.

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The opinions expressed on this blog are those of the author and are not to be construed as legal advice.

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