Shows
HortySpringer Health Law ExpressionsA Matter of (Advisory) OpinionOn this episode, HortySpringer attorneys Henry Casale and Hala Mouzaffar look at what happens when an OIG Advisory Opinion on pharmaceutical subsidies turns into a court battle over the language of the Anti-Kickback Statute. Listen now to this episode of The Kickback Chronicles to see what you can learn from the misfortune of others.2025-05-1418 minHortySpringer Health Law Expressions“But For” Keeps Coming Back for MoreHortySpringer attorneys Henry Casale and Hala Mouzaffar review how the “But For” test is changing the landscape of false claims cases brought in qui tam lawsuits. Listen now to this episode of The Kickback Chronicles to see what you can learn from the misfortune of others.2025-04-1012 minHortySpringer Health Law ExpressionsHow the One Purpose Test Can Turn a Free Meal into a Violation of the AKSOn this week’s episode, HortySpringer attorneys Henry Casale and Hala Mouzaffar dive into a case of alleged bribery to induce providers to prescribe a specific pharmaceutical drug that resulted in a new test for Anti-Kickback claims in the Second Circuit.Listen now to this episode of the “Kickback Chronicles” to see what you can learn from the misfortune of others.2025-02-0316 minHortySpringer Health Law ExpressionsIt’s Beginning to Look at Lot Like A Dangerous PhysicianIn this episode, HortySpringer attorneys Henry Casale and Hala Mouzaffar change gears and discuss how a surgery center could have prevented disaster with its credentialing and peer review processes. 2025-01-2024 minHortySpringer Health Law ExpressionsElection Year Update – IRS Rules on Political Activity by NonprofitsUnless you have been in a coma or hiding in the Witness Protection Program, you probably are aware that there is an election coming up in a few weeks. It is our right as Americans to vote and participate in the political process. But nonprofit organizations like hospitals and health systems that are tax exempt under Section 501(c)(3) of the Internal Revenue Code are prohibited from participating in political campaigns and may only have limited involvement in lobbying or attempting to influence public policy. HortySpringer partners Henry Casale and Dan Mulholland will review these rules and also discuss guidance...2024-10-0123 minHortySpringer Health Law ExpressionsPatient Safety Organizations – New Court Case Provides New OpportunitiesExciting news for those in the PSO world! The United States Court of Appeals for the Eleventh Circuit issued an opinion (In re Baycare Medical Group, 101 F.4th 1287 (11th Cir. 2024)) on May 14, 2024 that expands the scope of information, known as “Patient Safety Work Product,” protected by the Patient Safety and Quality Improvement Act (“PSQIA”). The Court rejects the “sole purpose” test articulated by other courts and the Department of Health and Human Services (“HHS”), finding that the test and HHS’s guidance “contradicts” the PSQIA’s final regulations. The “sole purpose” test was extremely limiting in what providers could categorize as Patient Safety...2024-08-1914 minHortySpringer Health Law ExpressionsFraud Runs In The FamilyHortySpringer attorneys Henry Casale and Hala Mouzaffar take a look at three clinics in rural Alabama to see how a physician’s disregard of warnings that her clinics were committing fraud led to the fall of the clinics, the physician, and the physician’s wife. Listen now to this episode of the The Kickback Chronicles to see what you can learn from the misfortune of others. 2024-08-1526 minHortySpringer Health Law ExpressionsThe Triple Crown of FraudOn this week’s episode, HortySpringer attorneys Henry Casale and Hala Mouzaffar dive into the case of a seasoned professional who found himself in the middle of not one, not two, but three different fraudulent healthcare schemes. Listen now to this episode of the “Kickback Chronicles” to see what you can learn from the misfortune of others. 2024-06-0518 minHortySpringer Health Law ExpressionsWhile You Were Sleeping: CMS Revises Guidelines on Informed Consent for Sensitive ExaminationsIt has been a longstanding practice within Hospitals across the U.S. for medical students and other practitioners-in-training to perform pelvic and other sensitive examinations on patients, most of whom are under anesthesia, without their explicit consent. Join Hala and Mary as they discuss the growing movement to better police this practice and how, as a result of mounting public scrutiny, it has caught the attention of CMS. 2024-05-1315 minHortySpringer Health Law ExpressionsUrine Trouble TooOn this week’s episode, HortySpringer attorneys Henry Casale and Hala Mouzaffar take a look at how some not-so-routine drug testing landed two providers in hot water. Listen now to this episode of the “Kickback Chronicles” to see what you can learn from the misfortune of others.2024-05-0915 minHortySpringer Health Law ExpressionsGun Jumping - Don’t Act Like You’re Merged Until You Are!When hospitals and health systems are pursuing a merger or affiliation, there is a natural tendency to move things along quickly. While it is ok to conduct due diligence, explore potential efficiencies and plan for what might be possible if the affiliation takes place, the parties need to refrain from acting like they are already affiliated, implementing plans or sharing competitively sensitive information such as payor contracts until the deal is done. To do so could constitute unlawful “gun jumping” in violation of federal antitrust rules, possibly subject the parties to fines and other penalties or even derail the tran...2024-05-0107 minHortySpringer Health Law ExpressionsSex, Drugs, and Rock & RollOn this week’s episode, HortySpringer attorneys Henry Casale and Hala Mouzaffar turn their attention to a small town in Tennessee to look at a provider that helped exacerbate the opioid crisis in his community for fame and fortune. Listen now to this episode of the “Kickback Chronicles” to see what you can learn from the misfortune of others.2024-04-1817 minHortySpringer Health Law ExpressionsBigger (and Broader) is Better When It Comes to ReleasesTwo recent lawsuits decided by Utah courts draw attention to the importance of strong, broad release language protecting physician leaders who volunteer to participate in credentialing, peer review, and other medical staff activities. In both cases, the physicians challenging peer review activity argued that the release language set forth in the Medical Staff Bylaws should not be applied to block their claims. One aggrieved physician claimed that the release language only applied to formal review and not collegial intervention efforts. The other claimed that the release language should not apply because the leadership allegedly violated the Bylaws while conducting...2024-03-2008 minHortySpringer Health Law ExpressionsBlood From a StoneOn this week’s episode, HortySpringer attorneys Henry Casale and Hala Mouzaffar take their first look at for-profit hospitals to discuss a unique case involving a hospital, its investors, and an attempt to avoid repaying Medicare. Listen now to this episode of The Kickback Chronicles to see what you can learn from the misfortune of others. 2024-03-0717 minHortySpringer Health Law ExpressionsDon’t Talk With Your Thumbs!CMS recently clarified that physicians can give orders via test in hospitals and critical access hospitals. But the texts have to be through a secure system, and computerized physician order entry is still preferred. Join HortySpringer attorneys Dan Mulholland and Mary Paterni as they discuss this new CMS guidance and also talk about the dangers of texting in general.2024-03-0709 minHortySpringer Health Law ExpressionsHometown HeroesOn this episode, HortySpringer attorneys Henry Casale and Hala Mouzaffar take a look at cases happening in their own backyard to show that healthcare fraud can happen anywhere. Listen now to this episode of the “Kickback Chronicles” to see what you can learn from the misfortune of others.2024-01-2521 minHortySpringer Health Law ExpressionsNew OIG General Compliance Program GuidanceThe Office of Inspector General recently published its General Compliance Program Guidance. The GCPG is a reference guide for the health care compliance community and other health care stakeholders. It is chock-full of information about relevant Federal laws, compliance program infrastructure, OIG resources, and other information useful to understanding health care compliance. While the GCPG is voluntary guidance and not binding on any individual or entity, it is an important roadmap to how the Government views the industry and how it intends to enforce the law. Join HortySpringer partners Henry Casale and Dan Mulholland for this new po...2023-12-0634 min