ANTITRUST – STATE-ACTION IMMUNITY DOCTRINE
N.C. State Bd. of Dental Exam’rs v. F.T.C.
No. 13-534 (U.S. Feb. 25, 2015)
EMPLOYED PHYSICIANS – PEER REVIEW PROCESS
Yedidag v. Roswell Clinic Corp.
No. 34,286 (N.M. Feb. 19, 2015)
Baney v. Fick
No. 4:14-CV-2393 (M.D. Pa. Feb. 23, 2015)
FALSE CLAIMS ACT
U.S. ex rel. Whipple v. Chattanooga-Hamilton Cnty. Hosp. Auth.
No. 13-6645 (6th Cir. Feb. 25, 2015)
FALSE CLAIMS ACT – “UPCODING”
U.S. ex rel. Oughatiyan v. IPC the Hospitalist Co.
No. 09C5418 (N.D. Ill. Feb. 17, 2015)
YOUR GOVERNMENT AT WORK
OIG Issues Advisory Opinion No. 15-03
On March 2, 2015, the Department of Health and Human Services Office of Inspector General (“OIG”) posted Advisory Opinion No. 15-03, which involved the proposed use of a “preferred hospital” network as part of Medicare Supplemental Health Insurance (“Medigap”) policies, in which the Medigap plan would indirectly contract with hospitals for discounts on the otherwise applicable Medicare inpatient deductibles for its policyholders and also provide a premium credit at the next time of policy renewal for policyholders who use a network hospital for an inpatient stay. The OIG concluded that the proposed arrangement would not be subject to civil monetary penalties or administrative sanctions.
CMS Extends Deadlines for Meaningful Use Attestations
The Centers for Medicare & Medicaid Services (“CMS”) has extended the deadlines to March 20, 2015 for: (a) eligible professionals to attest to meaningful use of electronic health records for the Medicare Electronic Health Record (“EHR”) Incentive Program; and (b) claims data submissions for the Physician Quality Reporting System. Additionally, this March 20, 2015 deadline extension also applies to and permits eligible professionals – who have not already switched – to switch between the Medicare and Medicaid EHR Incentive Programs for the 2014 payment year.