Andrew Wachler, principal of Wachler & Associates, P.C., was quoted in today’s Detroit Free Press regarding the Detroit Medical Center’s (DMC) $30 million settlement with the Federal government for violations of the Anti-Kickback Statute and Stark for improper financial relationships with referring physicians. Mr. Wachler stated that the DMC case…
The Department of Health and Human Services Office of Inspector General (OIG) released an unfavorable Advisory Opinion involving a transportation supplier’s proposal to offer skilled nursing facilities (SNFs) two payment plans for transportation of the SNF’s Medicaid-covered residents. The OIG determined that the arrangement could potentially violate the Anti-Kickback Statute…
The Detroit Free Press reported that the Detroit Medical Center has agreed to pay $30 million to the federal government to settle claims that involved violations of the Anti-Kickback Statute and Stark from improper financial relationships with referring physicians. The majority of the relationships at issue in the DMC matter…
The Department of Health and Human Services (HHS) Office of Inspector General (OIG) reported $25.9 billion of expected recoveries and savings in fiscal year (FY) 2010. The large amount is a combination of audit receivables, investigative receivables and other legislative and cost-saving actions that OIG recommended. In addition, the OIG’s…
Last week President Obama signed legislation that will delay Medicare payment cuts for one more year. The reduction in pay, 25 percent, had been scheduled to begin on January 1, 2011. The American Medical Association strongly advocated for the delay that is longer than the previous five delays over the…
The U.S. District Court for the Eastern District of Virginia ruled that Section 1501 of the Patient Protection and Affordable Care Act (PPACA) is unconstitutional. Shortly after PPACA was passed in March 2010, Virginia passed a state statute that conflicted with the individual mandate found in Section 1501 of PPACA…
Last week, the House and Senate passed the “Red Flag Program Clarification Act of 2010.” The Act limits the definition of “creditor” to a person who obtains or uses consumer reports in connection with a credit transaction, furnishes information to consumer reporting agencies in connection with credit transactions, or advances…
The United States Justice Department reported that in 2009 it collected $3 billion from pursuing health care fraud and other false claims against the federal government. More than 80% of the recoveries were from healthcare fraud, including qui tam actions under the False Claims Act. Bloomberg News reported that Tony…
The proposed purchase of the Detroit Medical Center by Vanguard Health Systems Inc. has been conditionally approved by the Attorney General of Michigan Mike Cox. This sale would bring a purported $1.5 billion in funding for the center. The deal is tentatively set to take place on December 31, 2010…
As the focus on health care fraud continues within the federal government, Department of Health and Human Services Kathleen Sebelius and Attorney General Eric Holder recently participated in the third regional health care fraud prevention summit in Brooklyn, New York. The stated purpose of the summit was to bring together…