Ober | Kaler Health Law Alert: 2016 Issue 11

 SPECIAL FOCUS: FRAUD AND ABUSE

Senate Finance Committee Report Concludes Stark Law Change is Necessary to Drive Health Care Reform

The Senate Committee on Finance has issued a report highly critical of the Stark law in its current form, labeling it “increasingly unnecessary for, and a significant impediment to, value-based payment models.”  The Senate report further outlines suggested changes to the Stark law in order to facilitate and encourage provider participation in alternative payment models. Cathy Martin and Samantha Flanzer explain both the Senate report’s critique of, and suggested changes to, the Stark law. Click to continue…

OIG Permits Copayment Coupon Arrangement for Statutorily Non-Covered Drug in Advisory Opinion 16-07

In OIG Advisory Opinion 16-07, the OIG approved a savings card program that would provide discounts to Medicare Part D beneficiaries for a drug that is statutorily excluded from coverage. Bill Mathias and Matthew Horton explain the OIG’s analysis of the fraud and abuse risks associated with the savings card program. Click to continue…

WHITE COLLAR

Health Care Fraud Prosecutions: Strong Seas and High Winds Ahead for Individuals and Corporations

The Department of Justice has indicated through policy pronouncements over the last nine months that it will continue to aggressively carry out civil and criminal health care fraud enforcement efforts. Gina Simms examines the DOJ’s recent activities and suggests several courses of action for individual providers and corporations to protect against the DOJ’s aggressive measures. Click to continue…

TECHNOLOGY

Telemedicine Gains Further Acceptance

Recent ethical guidance from the American Medical Association regarding the practice of telemedicine and telehealth, coupled with the incorporation of expanded telehealth payment policies in CMS’s proposed 2017 Medicare Physician Fee Schedule, indicate that telemedicine’s acceptance as a valid and needed model of medical service delivery continues on the upswing. Emily Wein discusses the AMA’s guidelines for using telemedicine as a method of treatment, and highlights the proposed payment changes introduced by CMS. Click to continue…

Health Law Alert® is not to be construed as legal or financial advice, and the review of this information does not create an attorney-client relationship.

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