Legal & Regulatory Issues

The Office of the Inspector General of the Department of Health and Human Services (OIG) issued Advisory Opinion No. 08-22 on Dec. 8, 2008. In the Advisory Opinion, the OIG analyzed a proposed arrangement under which a non-profit, tax-exempt corporation…

The American Hospital Association has sent a legislative health reform proposal to Congress recommending a number of significant changes including a renewed ban on physician self-referrals.

Seven hospitals in New York are accused of fraudulently billing Medicaid for more than $50 million, according to a report by the Associated Press.

Durable medical equipment (DME) suppliers have come under further scrutiny from CMS as the organization has announced a series of anti-fraud measures.

Commonwealth Medical Center in Aliquippa (Pa.) has closed and had its operating license revoked, a week after the facility filed for bankruptcy, according to the Pittsburgh Post-Gazette.

Northwestern Memorial Hospital has received subpoenas from federal investigators looking for possible Medicare fraud, according to a Chicago Sun-Times story referencing a Crain's Chicago Business report.

New York has recovered $551 million of improperly paid Medicaid funds through the fraud and abuse efforts of several New York agencies in fiscal year 2008, according to a press release from the New York governor’s office.

A proposed Minnesota law would require medical device manufacturers to publicly report gifts and payments to physicians, according to the Minneapolis Star Tribune.

A lawsuit alleging federal racketeering charges against Peoria (Ill.) Day Surgery Center and Joseph Banno, MD, brought on by OSF Saint Francis Medical Center has been dismissed by the U.S. District Court in Peoria.

During fiscal 2007, the federal government won or negotiated approximately $1.8 billion in judgments and settlements in healthcare fraud cases and proceedings, according to the annual report of the Health Care Fraud and Abuse Control Program (HCFAC).