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Compliance Update
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Tuesday, 12 May 2020 00:00
 
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Last Updated on Tuesday, 12 May 2020 17:43
 
State Surgeon General Issues Order 20-007 Print E-mail
Written by Susan St. John   
Monday, 11 May 2020 00:00

In my last post, I promised to keep you updated as to any new orders from the State Surgeon General that would further extend a practitioner's ability to prescribe refills of non-malignant pain controlled substances using telehealth communications, or a qualified physician's ability to recertify an existing qualified patient's use of medical marijuana. The Surgeon General has extended the ability to continue assisting patients with these specific needs (as well as other needs) until May 31, 2020, through the issuance of Emergency Order 20-007 on May 9, 2020.

Last Updated on Tuesday, 12 May 2020 17:44
 
CARES Act Funding Creates Dilemma for Some Healthcare Providers Print E-mail
Written by Vitale Health Law   
Monday, 04 May 2020 00:00

On March 27, 2020, President Trump signed the Coronavirus Aid, Relief and Economic Security (CARES) Act which provides $100 billion in relief funds to hospitals and other healthcare providers who are on the front lines of the COVID-19 response. Many providers have been receiving these funds without having applied for them. However, in order to keep the monies, providers must attest to the Terms and Conditions. After reading through some of the provisions, some are now concerned about whether to accept the funding or send it back. Among some of the key provisions:
  • The recipient must certify they are not currently terminated from participating in Medicare, Medicaid or other federal healthcare programs and do not currently have Medicare billing privileges revoked.
  • The recipient must certify that the payment is used only to prevent, prepare for and respond to COVID-19 and/or its complications and that the patients identified on the claim form were uninsured individuals at the time the services were provided.
  • The recipient must certify that the money will not be used to reimburse expenses or losses that have been reimbursed from other sources, or that other sources are obligated to reimburse.
Last Updated on Tuesday, 05 May 2020 15:07
 
Surgical Device Company Charged in Whistleblower Case Involving Kickbacks Print E-mail
Written by Vitale Health Law   
Monday, 09 March 2020 00:00

The Justice Department this month intervened in two whistleblower cases involving SpineFrontier Inc., related entities and executives. It is alleged that kickbacks were paid to spine surgeons to induce them to use SpineFrontier's surgical devices, a violation of the Anti-Kickback Statute (AKS). The AKS prohibits offering, paying, soliciting, or receiving remuneration to induce referrals of items or services covered by Medicare, TRICARE, and other federally funded programs. It is intended to ensure that a physician's medical judgment is not compromised by improper financial incentives. It is alleged in the complaint that approximately surgeons were paid more than $8 million in sham consulting fees for product evaluations, which were, in reality, payments in exchange for using the devices. The surgeons, in turn, generated more than $100 million in revenue for SpineFrontier, according to the complaint.

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Last Updated on Tuesday, 10 March 2020 17:32
 
OIG Gives Drug Manufacturer Green Light to Cover Patient Expenses Print E-mail
Written by Vitale Health Law   
Monday, 03 February 2020 00:00

The Office of Inspector General (OIG) in a Jan. 21 Advisory Opinion (No. 20-02) approved an agreement under which a pharmaceutical manufacturer would provide travel, lodging and other expenses to financially needy patients prescribed the manufacturer's personalized medication. In doing so, the OIG noted that such an arrangement could potentially violate the Anti-Kickback Statute, (AKS) and the Beneficiary Inducements of the CMP. However, under the limited circumstances of this particular arrangement, the watchdog agency said it would not impose sanctions.
 
Last Updated on Tuesday, 18 February 2020 09:46
 
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