With the global telehealth market projected to more than quadruple in value over the next five years, even slow-moving government payors have responded to the pressure to expand reimbursement options for telemedicine services. But reimbursement woes continue to top the list of concerns voiced by providers, and the U.S. Department of Health and Human Services, Office of Inspector General (“OIG”) is keeping a watchful eye on reimbursement-related growing pains. On April 30, 2018, OIG released a report that identifies the impact of some of these growing pains on Medicare claims payments. Continue Reading Telehealth Trend: Are Your Claims Reimbursable Under Medicare?
The National Labor Relations Board (the “Board”) recently held that a California hospital illegally maintained a dress code policy that effectively prohibited employees from wearing pins and badge reels with union insignia. The hospital’s policy at issue required that “[o]nly [employer] approved pins, badges, and professional certifications may be worn.” In addition, employees were only permitted to wear identification badge reels with “approved logos or text.” Continue Reading NLRB Prohibits Hospital from Banning Union Pins or Badges
For those of you who may have lost hope regarding the patentability of personalized medicine discoveries, here’s some encouragement. Recently the Federal Circuit affirmed the validity of a patent directed to a method of treating schizophrenia, which is based on genetic testing of the patient. Vanda Pharms. Inc. v. West-Ward Pharms. Int’l Ltd., Nos. 2016-2707, 2016-2708, 2018 WL 1770273, —F.3d — (Fed. Cir. Apr. 13, 2018). The Court found that the claims of U.S. Patent No. 8,586,610 were patent eligible and not drawn to a law of nature under 35 U.S.C. § 101. Claim 1 is representative and is shown below: Continue Reading Personalized Medicine Patents: Federal Circuit Gives Personalized Medicine Patents a Shot In The Arm
On April 2, 2018, Colorado Governor John Hickenlooper signed Senate Bill 18-082 into law. Senate Bill 18-082 amends Colorado’s non-compete statute, C.R.S. § 8-2-113, and curtails the ability of a former employer to enforce a non-compete agreement against a departing physician by seeking damages when the physician is treating patients who have “rare disorders.” The stated purpose of this law is to protect patients with rare disorders who would otherwise not have ready access to a physician with the necessary expertise to treat the disorder. Continue Reading Unintended Consequences? Amendment to Colorado’s Non-compete Statute for Physicians
The United States Department of Justice (“DOJ”) has intervened in a False Claims Act (“FCA”) case against a Florida compounding pharmacy, Diabetic Care Rx, LLC d/b/a Patient Care America (“PCA”), and, in an unexpected move, named PCA’s private equity sponsor and controlling shareholder, Riordan, Lewis & Haden, Inc. (“RLH”), as a co-defendant. The DOJ complaint accuses PCA, RLH and two PCA officers/directors (who were also RLH partners) of overseeing a kickback scheme which DOJ alleges induced referrals that resulted in TRICARE paying over $68 million for medically unnecessary compound drug prescriptions. DOJ alleges the illegal scheme was designed by RLH.
Earlier this month, Uber released its new program, Uber Health. In a nutshell, Uber Health is a program that facilitates patient transportation to and from appointments with healthcare providers. This post expands on a previous post regarding patient ridesharing programs. Continue Reading Need a Lift? Uber Enters the Healthcare Arena
In the last two months, the healthcare industry has seen both federal and state efforts to further regulate healthcare worker safety. Stakeholders and other jurisdictions are keeping an eye on these developments, which could spread to other states, as well.
While the federal legislation is focused on reducing workplace violence at healthcare facilities, an initiative in California will decide what additional regulations should be imposed to remove surgical plume and limit the exposure of healthcare professionals to surgical smoke in the state’s operating rooms. Continue Reading In healthcare worker safety, California leads the way
The debate over providing transportation to patients is nothing new. Hospitals, doctors and other providers have long struggled with whether they can provide free or discounted taxis, shuttles, metro cards or other transportation means to patients to come to appointments and receive care. On one hand, there is evidence that without reliable transportation options, patients are more likely to miss preventative, primary care appointments, increasing the risk of more costly and unnecessary medical services down the road. On the other hand, certain federal laws like the Anti-Kickback Statute (AKS) and Civil Monetary Penalty (CMP) law have given providers serious concerns that such transportation services might be considered an illegal “kickback” to gain patients, or an illegal inducement to receive care. Continue Reading What Health Care Providers Need to Know About Patient Rideshare
The Austin City Council is scheduled to vote Thursday, February 15 on a proposed city ordinance which would require all private businesses in the city to offer employees at least 8 paid sick days (or 64 sick leave hours) annually.
Under the proposed ordinance, employees would accrue 1 hour of paid sick leave for every 30 hours worked, with the ability to start using the sick leave as soon as it is earned. If passed, eligible workers would be able to use sick time if they are hurt or ill, need to care for a family member who is injured or sick, require medical attention or have a doctor’s appointment for preventative care, among other things. If an employee does not utilize all earned sick leave during the applicable year, any accrued, unused leave may be “rolled over” to the next year. Continue Reading Austin City Council to Consider Mandatory Paid Sick Leave
On January 10, 2018, citing costs associated with record increases in the number of qui tam actions filed under the False Claims Act, the Department of Justice issued a memorandum to certain DOJ attorneys, strongly signaling the Department’s intent to liberalize its use of section 3730(c)(2)(A) to seek dismissal of qui tam actions.
In the recently leaked memo, Michael Granston, Director of the Fraud Section of DOJ’s Commercial Litigation Branch, outlines “a general framework for evaluating when to seek dismissal” by identifying seven factors that have supported DOJ’s previous successful dismissal requests and emphasizes that the Department views its dismissal authority as one subject only to “highly deferential” review by the courts. The memo suggests DOJ will seek dismissal of these actions more often, making use of its authority to seek dismissal as “an important tool to advance the government’s interests, preserve limited resources, and avoid adverse precedent.” As further indication that the Department intends to pursue aggressively any available means of dismissal of these cases, the Director also recommends asserting in the alternative other independently available grounds for dismissal or requesting partial dismissal where appropriate, and the memo reminds attorneys that dismissal may occur at any stage of the proceedings, depending on the circumstances. The Director also stresses the importance of communication between the DOJ, the affected agency, and relators as a means of encouraging voluntary dismissal. Continue Reading DOJ Signals More Liberal Exercise of Power to Dismiss Qui Tam Actions under the FCA