Affordable Care Act | The Health Law Firm Blog

Top Medicare Prescribers Collect Speaking Fees from Drug Makers-Coincidence?

By Lance O. Leider, J.D., The Health Law Firm and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

A recent investigation by ProPublica found that certain doctors who prescribed certain drug brands the most, also have financial ties to the companies that manufacture those prescription drugs. Using Medicare payment data, ProPublica and National Public Radio (NPR) researched physicians who prescribed the most heavily promoted drugs of 2010 and 2011. It was discovered that many of the doctors allegedly had financial relationships with prescription drug manufacturers. ProPublica states that they initiated this investigation out of fear that pharmaceutical payments are influencing […]

By The Health Law Firm|2024-03-14T10:00:50-04:00June 1, 2018|Affordable Care Act, Health Care Industry, Medicare, Pharmaceutical Drugs, The Health Law Firm Blog, Whistleblower|

CMS Fights Medicare Fraud With Ban on New Home Health Agencies and Ambulance Suppliers in Three Cities

By Lance O. Leider, J.D., The Health Law Firm and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

The Centers for Medicare and Medicaid Services (CMS) announced it will temporarily ban new home health providers and ambulance suppliers from enrolling in Medicare, Medicaid and the Children’s Health Insurance Program (CHIP) in three fraud “hot spots.” According to CMS, the six-month moratorium begins July 30, 2013. It applies to newly enrolling home health agencies (HHAs) in Miami, Florida, and Chicago, Illinois. It also applies to newly enrolling ambulance suppliers in Houston, Texas. Existing providers and suppliers can continue to deliver and bill […]

By The Health Law Firm|2024-03-14T10:00:51-04:00June 1, 2018|Affordable Care Act, In the Know, In the News, Medicare, Medicare Fraud, The Health Law Firm Blog|

Physician Payment Sunshine Act Deadline is Here-Are You Ready?

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law and Lance O. Leider, J.D., The Health Law Firm

As of August 1, 2013, the Physician Payment Sunshine Act (Sunshine Act) goes into effect. The Sunshine Act, contained in Section 6002 of the Patient Protection and Affordable Care Act (PPACA), is designed to highlight the financial relationship between doctors and the manufacturers of medical devices and pharmaceuticals. The act requires that light be shined on the payments being made to physicians by pharmaceutical and medical device manufacturers, bringing these out into the “sunshine.”

Some of the items tracked include gifts worth more than $10, […]

By The Health Law Firm|2024-03-14T10:00:51-04:00June 1, 2018|Affordable Care Act, Health Care Industry, In the Know, The Health Law Firm Blog|

CMS Extends Waivers under the ACO Shared Savings Program

By Lance O. Leider, J.D., The Health Law Firm

On November 2, 2011, the Centers for Medicare and Medicaid Services (CMS) promulgated the interim final rule on fraud and abuse waivers for Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program. The interim rule can be found at 76 Fed. Reg. 67801. The waiver was granted pursuant to the agency’s authority under the Affordable Care Act, specifically, 42 U.S.C. § 1899(f).

You can read our prior blog postings on the ACO waiver programs here.

Normally, interim final rules are only permitted to remain in effect for a maximum of three years […]

By The Health Law Firm|2024-03-14T10:00:58-04:00June 1, 2018|ACO, Affordable Care Act, The Health Law Firm Blog|