Will The Standard of Liability Under The 60-Day Repayment Rule Change?

Posted by Aselle Kurmanova on February 21, 2023
CMS, Repayment Rule / No Comments

At the end of last year, the Centers for Medicare & Medicaid Services (CMS) proposed changes to the so-called 60-day repayment rule. The proposed changes include eliminating the current “reasonable diligence” standard that applies to providers in connection with potential liability for overpayments and replacing it with “actual knowledge” or “acting with reckless disregard.” The proposed changes can be located here.

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New Protections for Employees of Certain New Jersey Health Care Entities

Posted by Aselle Kurmanova on October 27, 2022
Healthcare, New Jersey Health Care, Protection for employees / No Comments

Health care entities, home health care agencies, and staffing registries considering a transaction in New Jersey will need to keep in mind new obligations to certain employees. On August 18, 2022, Governor Murphy signed into law New Jersey Senate Bill No. 315 (the “Act”), which created broad protections for many employees in the health care sector in the event of a change in control. The Act requires any change in control to be made pursuant to a contract or agreement between the parties that preserves the wages, benefits, and employment status of eligible employees.

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Sham Transactions in Digital Health Industry

Posted by Aselle Kurmanova on September 23, 2022
Uncategorized / No Comments

In its recently published Special Fraud Alert, the Office of Inspector General (“OIG”) presented a list of suspect characteristics related to arrangements with telehealth and telemedicine companies, which may help determine the potential for fraud.

The OIG developed this list based on dozens of fraud investigations involving companies in the digital health space. The schemes investigated by the OIG varied in design and operations, as well as the types of entities and individuals involved. They implicated a whole slew of Federal laws, including, among others, violations of the Federal anti-kickback statute and the False Claims Act. These schemes raised significant fraud concerns because “of the potential for considerable harm to Federal health care programs and their beneficiaries.”

The list of suspect characteristics related to arrangements with telemedicine companies is as follows:

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