Shows
HortySpringer Health Law ExpressionsCuckoo for Coconut OilHortySpringer attorneys Henry Casale and Hala Mouzaffar discuss how a Ph.D. holder took the title “Doctor” a little too far. Listen now to this episode of The Kickback Chronicles to see what you can learn from the misfortune of others.
2025-12-1224 minHortySpringer Health Law ExpressionsUnlicensed and Ready to PracticeOn this week’s episode, HortySpringer attorneys Henry Casale and Hala Mouzaffar discuss how a home health agency used unlicensed foreign medical graduates to “assist” physicians in providing services. Listen now to this episode of The Kickback Chronicles to see what you can learn from the misfortune of others.
2025-12-0219 minHortySpringer Health Law Expressions“Speak No Evil” Can Come at a Cost to PatientsAll too often, a hospital’s response to peer evaluation, especially when there is negative information about the physician, is “name, rank, and serial number.” While this approach may be quick and easy, and feels like it is risk free, it may not be for the patients. The “speak no evil” approach compromises the ability of the hospital on the receiving end of the response from properly credentialing the applicant. Join us for episode two of Crash Course Credentialing, as HortySpringer attorneys Susan Lapenta and Lauren Massucci explore how you can share your concerns about a problem physician a...
2025-11-0543 minHortySpringer Health Law ExpressionsThe Buck Stops With the BoardThe Board is not just a rubber stamp. In Crash Course Credentialing, our new series on the Health Law Expressions Podcast, HortySpringer attorneys Susan Lapenta and Lauren Massucci explore how involved the Board should be in the credentialing process and the information that it should know in order to satisfy its legal obligations.
2025-10-1337 minHortySpringer Health Law ExpressionsPigs Get Fed, Hogs Get SlaughteredOn this week’s episode, HortySpringer attorneys Henry Casale and Hala Mouzaffar dive into how lavish speaking events cost a Pharmaceutical Manufacturer a whole lot more than what they bargained for. Listen now to this episode of The Kickback Chronicles to see what you can learn from the misfortune of others.
2025-10-0621 minHortySpringer Health Law ExpressionsHospice HavocIn this episode, HortySpringer attorneys Henry Casale and Hala Mouzaffar look at how a hospice provider frauded millions out of the Medicare program by concealing their true billing intentions. Listen now to this episode of The Kickback Chronicles to see what you can learn from the misfortune of others.
2025-09-1523 minHortySpringer Health Law ExpressionsExclusion ConfusionHortySpringer attorneys Henry Casale and Hala Mouzaffar look at how a physician was excluded from participation in all federal health care programs simply due to his position as Medical Director of a Pharmaceutical Manufacturer. Listen now to this episode of The Kickback Chronicles to see what you can learn from the misfortune of others.
2025-07-2918 minHortySpringer 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 minHortySpringer Health Law ExpressionsThe Kickback Chronicles: Where Are They Now?On this week’s episode of The Kickback Chronicles, HortySpringer attorneys Henry Casale and Hala Mouzaffar look back at cases they have discussed over the last year to see where the defendants are today, what sentences they actually received, and if any old habits die hard. Listen now to this episode to see what you can learn from the misfortune of others.
2023-08-2319 minHortySpringer Health Law ExpressionsFraud Will Cost You Your Yellow SubmarineOn this week’s episode of The Kickback Chronicles, HortySpringer attorneys Henry Casale and Hala Mouzaffar discuss a series of fraudulent schemes that spanned the West Coast. They take a deeper dive into how “one of the nation’s busiest” physicians got caught in a scheme riddled with fraud and abuse. Listen now to see what you can learn from the misfortune of others.
2023-08-0325 minHortySpringer Health Law ExpressionsDon’t Get Burnout from Your Wellness Program: The New Stark Exception and Anti-Kickback Safe Harbor for Wellness ProgramsIn the Congressional Appropriations Act passed in December 2022, Congress adopted a new Stark exception and Anti-Kickback safe harbor for wellness programs for physicians and other clinicians. Specifically, the new law provides that counseling, mental health services, suicide and substance abuse prevention programs offered by hospitals and other providers with a formal medical staff will not violate the Stark law or Anti-Kickback Statute so long as the are set out in a board-approved policy that meets five specific elements described in the statute.Join HortySpringer Partners Henry Casale and Dan Mulholland on this new Health Law Expressions podcast...
2023-07-1918 minHortySpringer Health Law ExpressionsFox in the Hen House a/k/a Compliance Officer Goes RogueThe Kickback Chronicles, Episode 18On this week’s episode, HortySpringer attorneys Henry Casale and Hala Mouzaffar discuss what happens when a Chief Compliance Officer stops performing in accordance with his job description and instead becomes the center of a fraudulent scheme. Listen now to this episode of The Kickback Chronicles to see what you can learn from the misfortune of others.
2023-07-1212 minHortySpringer Health Law ExpressionsWhat You Know Will Hurt YouThe U.S. Supreme Court recently held that in order to violate the False Claims Act, a defendant’s knowledge and subjective beliefs matter—not to what an objectively reasonable person may have known or believed. That case – U.S. ex rel Schutte v. Supervalu, Inc. – dispels the notion that defendants can skate on an FCA claims by coming up with after-the-fact justifications. Understanding this case and its implications is a must for any compliance officer or in house or external counsel in the health care field. Join HortySpringer partners Henry Casale and Dan Mulholland as they explain this...
2023-06-2821 minHortySpringer Health Law ExpressionsTesting Positive for Fraud The Kickback Chronicles, Episode 17On this week’s episode of The Kickback Chronicles, HortySpringer attorneys Henry Casale and Hala Mouzaffar examine a pharmacogenetic testing scheme spanning several states and take a closer look at the spider web of arrangements that frauded Medicare out of $28 million. Listen now to this episode of The Kickback Chronicles to see what you can learn from the misfortune of others.
2023-06-1312 minHortySpringer Health Law ExpressionsCatch Me If You Can—Health Care Edition The Kickback Chronicles, Episode 16On this week’s episode of The Kickback Chronicles, HortySpringer attorneys Henry Casale and Hala Mouzaffar examine one of their favorite archetypes: the repeat offender. They examine how a former PA already convicted for practicing without a license re-emerged years later to repeat her crimes. Listen now to this episode of The Kickback Chronicles to see what you can learn from the misfortune of others.
2023-05-2516 minHortySpringer Health Law ExpressionsMaster of Disguise The Kickback Chronicles, Episode 15On this week’s episode of The Kickback Chronicles, HortySpringer attorneys Henry Casale and Hala Mouzaffar examine a massive scheme involving a compound pharmacy and TRICARE. They take an especially close look at the lengths this group went to after they were caught to cover their trail and falsify documents—all in a fruitless effort to vindicate themselves of any wrongdoing. Listen now to this episode to see what you can learn from the misfortune of others.
2023-05-1022 minHortySpringer Health Law ExpressionsFriendship is in the Eye of the Beholder The Kickback Chronicles, Episode 14On this week’s episode of The Kickback Chronicles, HortySpringer attorneys Henry Casale and Hala Mouzaffar examine a scheme involving ophthalmology surgery equipment. In a scheme seemingly drenched in kickbacks, find out why the company and its owner decided to roll the dice and take their case to trial.
2023-03-3022 minHortySpringer Health Law ExpressionsRx-ploiting Medicare and Medicaid The Kickback Chronicles, Episode 13On this week’s episode of The Kickback Chronicles series, HortySpringer attorneys Henry Casale and Hala Mouzaffar see how encompassing pharmaceutical fraud can be by taking a closer look at three recent cases, each involving prescriptions, each entirely unique from the others, and each more expensive than the last. Listen now to this episode of the “Kickback Chronicles” to see what you can learn from the misfortune of others.
2023-03-1512 minHortySpringer Health Law ExpressionsUrine TroubleThe Kickback Chronicles, Episode 12On this week’s episode, HortySpringer attorneys Henry Casale and Hala Mouzaffar look at a North Carolina Medicaid fraud scheme in which Medicaid recipients were required to submit medical unnecessary urine specimens that were billed to the North Carolina Medicaid program in order to participate in subsidized housing programs, after school programs, and mental health and other clinics. Listen now to this episode of the “Kickback Chronicles” to see what you can learn from the misfortune of others.
2023-02-0712 minHortySpringer Health Law ExpressionsThe Pain Caused by Lying to the Feds The Kickback Chronicles, Episode 11On this week’s episode, HortySpringer attorneys Henry Casale and Hala Mouzaffar review the recent sentencing of two individuals connected with over prescribing Subsys, one of the drugs at the center of the opioid crisis. Listen now to this episode of the “Kickback Chronicles” to see what you can learn from the misfortune of others.
2023-01-2611 minHortySpringer Health Law ExpressionsMoving to a Three-Year Appointment Period – Is Now the Time?The Joint Commission announced in mid-December that, effective immediately, hospitals could begin reappointing and renewing clinical privileges for practitioners every three years, rather than every two years. This is nothing new for those hospitals accredited by the DNV, but with this announcement, many hospitals accredited by TJC are considering moving to a three-year appointment period. Before making this decision, there are several factors that you should evaluate. For example, what changes will you need to make to your Medical Staff governance documents, does state law permit you to reappoint practitioners every three years (some do not), and are there cha...
2023-01-0422 minHortySpringer Health Law ExpressionsThe Alchemy of FraudThe Kickback Chronicles, Episode 10On this week’s episode, HortySpringer attorneys Henry Casale and Hala Mouzaffar turn their focus to telemedicine fraud in the pharmaceutical industry. With help from an industry expert, they take a closer look at some common themes to look for and avoid in the pharmaceutical world. Listen now to this episode of the “Kickback Chronicles” to see what you can learn from the misfortune of others.
2022-12-1410 min
MaxWorth InsightsThe Call Pay Solution AnniversaryOn this episode of MaxWorth Insights, we’re celebrating the anniversary of our first call pay program with the help of the physician leader who made it possible.
Over fifteen years ago, Winchester Medical Center, a 495-bed facility in Virginia, was at risk of losing a service line in its emergency department due to a dispute over call pay. MaxWorth was brought on board to help the hospital come up with a sustainable approach to paying for call that would ease agitation and keep its ED fully staffed.
At the time, Dr. Tom Oliver, a urologist who had been on st...
2022-12-0732 minHortySpringer Health Law ExpressionsAin’t No Stopping It Now, Telemedicine Is Here to Stay!The Kickback Chronicles, Episode 9On this week’s episode, HortySpringer attorneys Henry Casale and Hala Mouzaffar dive into the world of telemedicine. The expansion of access to telemedicine services during the COVID-19 pandemic has opened the door to a whole new type of fraud. Join us as we take a closer look at how the OIG will be identifying and evaluating these types of cases as well as some of the most recent victims of the OIG’s crackdown on telemedicine. Listen now to this episode of the “Kickback Chronicles” to see what you can learn from t...
2022-10-0521 minHortySpringer Health Law ExpressionsBut For the Grace of Fraud Go IThe Kickback Chronicles, Episode 8On this week’s episode, HortySpringer attorneys Henry Casale and Hala Mouzaffar take a closer look at a recent case involving an alleged kickback scheme between an engaged couple on separate ends of a financial relationship. In what first appeared to be a shut and close case, now remains unfinished. Learn how just two words changed everything. Listen now to this episode of the “Kickback Chronicles” to see what you can learn from the misfortune of others.
2022-09-1520 minHortySpringer Health Law ExpressionsOops!... She Committed Fraud AgainThe Kickback Chronicles, Episode 7On this week’s episode of The Kickback Chronicles, HortySpringer attorneys Henry Casale and Hala Mouzaffar take a closer look at a recent case involving a woman who just couldn’t get enough of the Department of Justice. While awaiting sentencing for a guilty plea of health care fraud, this week’s schemer got herself involved in yet another Medicaid billing scheme. Listen now to this episode to see what you can learn from the misfortune of others.
2022-08-2310 minHortySpringer Health Law ExpressionsTo Catch a FraudsterThe Kickback Chronicles, Episode 6On this week’s episode, HortySpringer attorneys Henry Casale and Hala Mouzaffar flip the script and examine the government’s investigation tactics when examining fraud cases. As they walk through the process using a recent case, you will get a sense of the resources the government has at its fingertips and just what lengths it will go to prove fraud beyond a reasonable doubt. Listen now to this episode of the “Kickback Chronicles” to see what you can learn from the misfortune of others.
2022-08-0911 minHortySpringer Health Law ExpressionsProof of Vaccination RequiredThe Kickback Chronicles, Episode 5On this week’s episode, HortySpringer attorneys Henry Casale and Hala Mouzaffar look into the world of fraudulent COVID-19 Vaccination Cards by taking a deeper dive into two recent cases involving forged and fraudulent vaccination cards. Although fraudulent vaccination cards were the root of these crimes, you’ll be shocked to learn the series of events that led up to charges being filed and the subsequent guilty pleas entered. Listen now to this episode of the “Kickback Chronicles” to see what you can learn from the misfortune of others.
2022-07-2611 minHortySpringer Health Law ExpressionsFraud is in their GenesThe Kickback Chronicles, Episode 4On this week’s episode, HortySpringer attorneys Henry Casale and Hala Mouzaffar look at the recent guilty plea of the owner and operator of a marketing company that conducted business with medical testing companies. What began as a scheme to defraud Medicare out of funds related to genetic testing, turned into a bigger opportunity at the onset of the COVID-19 pandemic. This case will show the government’s crackdown on fraud in connection with COVID-19 and leave you wondering if this is just the tip of the iceberg. Listen now to this e...
2022-07-1317 minHortySpringer Health Law ExpressionsHave You Looked at Your Corporate Bylaws Lately? Do You Even Know Where They Are?Hospitals often review and revise their medical staff bylaws and policies to keep up with new developments, but many rarely or ever pay attention to their hospital corporate bylaws. Corporate bylaws are required to contain provisions required by CMS, the IRS, state licensure agencies, and accrediting bodies, but if they haven’t been updated in a while they may not meet these requirements. Corporate bylaws should also compliment and supplement medical staff documents, but if they are inconsistent with medical staff documents it can spell trouble if there is ever a dispute over credentialing or privileging. HortySpringer partn...
2022-07-0719 minHortySpringer Health Law ExpressionsBrace Yourself for FraudThe Kickback Chronicles, Episode 3On this week’s episode, HortySpringer attorneys Henry Casale and Hala Mouzaffar look at the recent conviction of the 3 owners of multiple orthotic brace supply companies across Texas. Together they set out to defraud Medicare out of nearly $6.5 million by violating the Anti-Kickback Statute. This case will leave you wondering how you even conceal these payments, and what is the price these owners stand to pay?Listen now to this episode to see what you can learn from the misfortune of others.
2022-06-2213 minHortySpringer Health Law ExpressionsTeen Substance Use Disorder Facility FraudThe Kickback Chronicles, Episode 2On this week’s episode, HortySpringer attorneys Henry Casale and Hala Mouzaffar take a closer look at the recent conviction of 3 individuals involved in a substance use disorder treatment facility’s scheme to defraud the California Medicaid program out of nearly $18 million over the course of 4 years. This case will have you asking: How many people can be convicted for a company-wide scheme?What causes so many people to participate in a fraudulent scheme?And who has to pay back all that money? Listen now to this episode of the “Kickback Chronicl...
2022-05-1914 minHortySpringer Health Law ExpressionsThe Kickback Chronicles: Learn from the Misfortune of OthersOver the years, the Department of Justice has increasingly cracked down on fraudulent billing and kickbacks provided to healthcare providers. Despite nearly $2 billion in recovery of illegal funds every year, providers continue to disregard these laws thinking their actions will go undetected. On this inaugural episode, HortySpringer attorneys Henry Casale and Hala Mouzaffar dive into a recent case involving a mobile x-ray provider, where a jury had to consider:• Can you bill dead patients and get away with it?• Does it matter that Medicare paid for fraudulent claims for years?• What are the rep...
2022-05-0919 minHortySpringer Health Law ExpressionsCMS COVID-19 Vaccine Mandate – What You Need to Know NOW!On November 5, 2021, CMS issued an interim final rule requiring hospitals and other facilities subject to Medicare Conditions of Participation to adopt a process or plan for vaccinating all eligible staff by December 6, 2021. Staff must be fully vaccinated by January 4, 2022. This not only applies to employees but also medical staff members, trainees, independent contractors, and others. HortySpringer attorneys Dan Mulholland and Nick Calabrese break down the new regulation for you and tell you what you need to do NOW to get ready for compliance. Aside from explaining the new rule, the podcast discusses: · What happens if you...
2021-11-1131 minHortySpringer Health Law ExpressionsNew OSHA Emergency Temporary COVID Standard for Healthcare Employers – More Questions than Answers?This podcast summarizes the requirements in OSHA’s new COVID-19 Emergency Temporary Standard (“ETS”) for employers in the healthcare setting. While the ETS is long and detailed, some healthcare settings are exempt from its requirements. Join HortySpringer attorneys Dan Mulholland and Philip Zarone to learn what healthcare employers must do to comply and where they can turn for additional information.
2021-06-1723 minHortySpringer Health Law ExpressionsMandatory Vaccinations for Hospital EmployeesHouston, do we have a problem?Join HortySpringer attorneys Dan Mulholland and Nicholas Calabrese as they explore the rules and risks of mandatory vaccination programs for hospital employees, including a discussion of the Houston Methodist Hospital vaccination program case.
2021-06-1619 minHortySpringer Health Law ExpressionsUS v. Shah – New Intent Test for KickbacksThe OIG and the Courts have long taken the position that a person who pays an alleged kickback can be sent to prison if the government can prove that merely “one purpose” of the payment of the kickback is to induce the referral of business that is paid for, in whole or in part, by a federal healthcare program. But what about the recipient of the kickback? What must the government prove in order to convict the recipient of the kickback? In a case of first impression, a federal circuit court’s answer to this question is nothing—the recipient’s...
2021-05-2716 minHortySpringer Health Law ExpressionsHow To Fix A Stark ProblemHave you discovered that one of your physician contracts is out of compliance with the Stark Law? You may be able to fix it. CMS has now developed a new way to correct noncompliance with the Stark Law without having to make a formal self-disclosure. The recently revised Stark Regulations, at 42 CFR §411.357(h) of the new regulations, sets forth a special rule for correcting technical deficiencies and even reconciling compensation that might be in excess of fair market value. Tune into this episode where Dan Mulholland and Joshua Hodges explain how this new rule can wor...
2021-04-0810 minHortySpringer Health Law ExpressionsNew Executive Order on Regulatory Relief – A Trump Card to Play Against the Government?On May 19, 2020, President Trump issued an Executive Order on Regulatory Relief to Support Economic Recovery. The purpose of the Executive Order was to remove regulatory barriers to economic recovery from the effects of coronavirus lock downs throughout the country. The Order primarily directs federal agencies to address the current economic emergency by rescinding, modifying, waiving, or providing exemptions from regulations and other requirements that may inhibit economic recovery. But it goes farther than that. Among other things, it directs agencies to not just temporarily but permanently rescind regulations, accelerate pre-enforcement ruling procedures, decline enforcement against persons and entities that...
2020-06-0216 minHortySpringer Health Law ExpressionsPhysician Burnout – Addressing a Public Health Crisis Worsened by the COVID-19 PandemicUnder normal circumstances, physician burnout has been described as a “public health crisis” resulting in high turnover rates, inefficiency, increased medical errors, and exit from the profession. Some surveys show that nearly half of all physicians experience burnout in some form. While burnout has been attributed to numerous factors, including the demands of electronic health records and a reduction in physician autonomy, it is almost certainly going to increase and be exacerbated as a result of the current pandemic. Physicians in COVID-19 hotspots can be treating an overwhelming amount of critically ill patients and confronting death rates unlike anything they...
2020-05-1822 minHortySpringer Health Law ExpressionsPaycheck Protection Program – Proceed with Caution!If your organization has received a loan from the new Paycheck Protection Program, congratulations! But like any government program, be careful! There are always strings attached. Recent controversy about large organizations getting assistance has caused regulators to warn that if you keep the money but are later found to not need it, you could be in big trouble. To help you understand what may be at stake, tune into this timely podcast, where HortySpringer attorneys Phil Zarone and Dan Mulholland describe what you must do to document that you may not be able to cover payroll, rent o...
2020-05-0412 minHortySpringer Health Law ExpressionsCoronavirus Fraud and Abuse Issues: Protections and PitfallsMany federal agencies have weighed in with various waivers, policy statements and guidance regarding arrangements between and among health care providers and their patients to address the COVID-19 pandemic. These include several blanket waivers by CMS of sanctions under the Stark Law and an OIG Policy Statement declining to impose administrative sanctions under the Federal anti-kickback statute. These actions are helpful, but should not be a blanket license to ignore these laws. In this special podcast, HortySpringer partners Dan Mulholland and Henry Casale review the recent guidance, explain what you can and can’t do and look ahead to th...
2020-04-0837 minHortySpringer Health Law ExpressionsThinking of a Joint Venture? Look Before You Leap!In today’s deal happy world, we’re seeing joint ventures make a comeback. Joint ventures come in all shapes and sizes; some are with physicians, some with other business partners, and some are with people you’ve never met before. Join faculty Dan Mulholland and Henry Casale as they discuss these ventures and the questions you should ask and get answered before you commit.
2020-02-1216 minHortySpringer Health Law ExpressionsUS ex rel. Bookwalter — The Shape of Stark to Come Horty Springer and Mattern partners Dan Mulholland and Henry Casale discuss a False Claims Act case that was based on the Stark Law in which the Third Circuit Court of Appeals interpreted the Stark Law to question whether most RVU compensation models were permitted by the Stark Law. However, as proof that not even the federal courts understand the Stark Law, the Third Circuit vacated its September 17th decision and reissued its opinion on December 20. The new Opinion corrected some of the more egregious errors that were included in the September Opinion. However, it still leaves a number of q...
2020-01-2314 minHortySpringer Health Law ExpressionsThe Who, What, When and Why of Information SharingInformation Sharing in Healthcare is discussed in this episode;Who shares: Hospitals and Health Systems, Physician groups, joint ventures etc.What is shared: This should be an organizational decision set forth in a policy. May share things such as all OPPE, FPPE, PPE information, good standing letters, external reviews or as little as name, rank and serial numberWhen do you share: At initial appointment, reappointment, when a specified step occurs in a performance improvement plan, formal investigations, evaluations, when an adverse action is recommended.Why do you share: Patient safety is the number one...
2019-08-2614 minHortySpringer Health Law ExpressionsState False Claims Acts - Something Else to Keep You Up At Night Horty Springer and Mattern partners Dan Mulholland and Henry Casale discuss very recent developments from the Office of Inspector General of HHS in terms of reviewing the False Claims Act at the State level and whether it complies with federal rules. Discussion includes a review of the False Claims Act to see if states will qualify for a 10 percent increase in any share of a False Claims Act settlement.
2019-03-2912 minHortySpringer Health Law ExpressionsMedical Marijuana and Employment: A Hot Box of IssuesJosh Hodges and Katie Pakler of Horty Springer and Mattern discuss the latest issues in regard to medical marijuana laws at the state level and how it can affect an employment policy. Josh and Katie discuss recent employment discrimination cases from a few different states that have legalized the use of medical marijuana. Many states are continuing to add new marijuana use laws, Josh and Katie explain how to keep on top of these laws and the importance in knowing them when crafting employment policy.
2019-03-2910 minHortySpringer Health Law ExpressionsPatient Safety Organizations at the CrossroadsDan Mulholland and Charlie Chulack, partners at Horty Springer and Mattern discuss recent developments at the state and federal level dealing with Patient Safety Organizations.
2018-11-0213 minHortySpringer Health Law ExpressionsExcess Compensation Causes Excess TroubleDan Mulholland and Henry Casale, senior partners at Horty Springer and Mattern, discuss the implications of the changes in tax laws that will impose excise tax on excess compensation paid by exempt organizations.The so-called Triple Ex Provision.
2018-11-0213 minHortySpringer Health Law ExpressionsBurnoutIan Donaldson partner at the firm Horty Springer and Mattern discusses the growing problem of physician burnout and how to help educate, receive and process feedback and eliminate the frustrations experienced by your medical staff.
2018-11-0207 minHortySpringer Health Law ExpressionsOverwhelmed in the Medical Staff OfficeIan Donaldson and Joshua Hodges of Horty Springer and Mattern share ideas on how to lesson the overwhelming process of credentialing faced by medical staff offices. Listen as they share insightful tips learned from many years of helping hospitals and healthcare systems of all sizes.
2018-11-0209 minHortySpringer Health Law ExpressionsThe Nahas Case — A Jersey Shore SituationDan Mulholland and Susan Lapenta explore the ins and outs of the Nahas Case.
2018-10-2416 min