Media Mentions
2008
Daniel H. Melvin was quoted in the July 7 issue of Modern Healthcare in an article regarding CMS' newly proposed rules for gain-sharing and other pay-for-performance initiatives that could be a significant step toward loosening financial-arrangement restrictions that many believe prevent doctors and hospitals from aligning on quality-improvement and cost-savings efforts. "The OIG has never wavered from its opinion that gain-sharing violates the law, but in cases where hospitals have sought its opinion (about implementing gain-sharing) the OIG has said it wouldn't prosecute. But, I do think that hospitals will seek to develop programs now that a government agency is looking favorably on gain-sharing,'' Mr. Melvin said.
Daniel H. Melvin, Health, Reimbursement/Fraud & Abuse
2007
Monte Dube was quoted in the June 29 issue of Modern Healthcare regarding Richard Scrushy, former HealthSouth Corporation CEO, being sentenced for over seven years and ordered to pay $50,000 in fines for paying former Alabama Gov. Don Siegelman to obtain a seat on the state certificate-of-need board for a HealthSouth representative. “In some states, CON has long had a reputation for being a political/regulatory cesspool. The message generally is when you jump in, you better play by the rules or be prepared to pay the price,” Mr. Dube said.
Monte I. Dube, Health, Health Care Litigation, Reimbursement/Fraud & Abuse
2006
Ankur J. Goel was quoted in the December 25 issue of Report on Medicare Compliance on the Deficit Reduction Act's False Claims Act requirements, stating that "whether entities need to be in complete 100% compliance on Jan. 1 is debatable because the states haven’t instituted the requirements yet and this guidance just came out," Mr. Goel said. "If entities are in substantial compliance or have taken steps in good faith, they should be in good shape," he added.
Ankur J. Goel, Health, Reimbursement/Fraud & Abuse
Timothy Blanchard has been listed as one of Nightingale's Healthcare News' "Outstanding Fraud & Compliance Lawyers -- 2006" in the May issue. Tim was recognized for his focus on healthcare regulatory issues, including Medicare and Medicaid billing and payment, healthcare compliance programs, HIPAA privacy, fraud and abuse audits and investigations, managed care, and utilization review.
Timothy P. Blanchard, Health, Reimbursement/Fraud & Abuse
Timothy Blanchard was listed as one of Nightingale's Healthcare News' "Outstanding Fraud & Compliance Lawyers--2006" in the May issue.
Timothy P. Blanchard, Health, Reimbursement/Fraud & Abuse
2005
Eric Gordon was listed as one of Nightingale's Healthcare News' "Outstanding Fraud & Compliance Lawyers - 2005," in the May/June issue. Mr. Gordon was recognized for his experience in developing compliance plans, structuring complex business transactions and developing compensation plans for academic medical centers, hospital systems, medical device manufacturers and research institutes. He was also recognized for his work as Stark counsel in False Claims Act qui tam litigation.
Eric B. Gordon M.D., Health, Reimbursement/Fraud & Abuse
2004
Eric Zimmerman offered advice to the readers of Gastroenterology Coder's Pink Sheet (July 2004) on how to resolve the problem of improper pay for E/M and screening colonoscopies by stating "if a provider or physician becomes aware that they are in possession of an overpayment, CMS and the Inspector General believe that there is an obligation to make a repayment back to Medicare." Mr. Zimmerman also commented on the appropriate action time and how to go about refunding overpayments.
Eric Zimmerman, Health, Reimbursement/Fraud & Abuse
Max Reynolds was quoted in the article, "Phase II Final Regs Reduce Self-Referral Rule Burdens, Add Flexibility," published in the March 31 issue of BNA Health Care Fraud Report. The article reports how the second part of the Stark II interim rule reduces self-referral rule burdens in several areas affecting physician referrals to entities with which they or their families have a financial relationship. Mr. Reynolds said that the second phase guidance affords hospitals located in a health professional shortage area "some flexibility" in offering physician retention payments. However, "CMS also appears to have abandoned its earlier interpretation that certain types of agreements involving administrative services or utilization review services could be protected from the Stark law on grounds that they are 'unrelated' to the furnishing of [designated health services]," he added.
, Health, Reimbursement/Fraud & Abuse
2003
Eric Zimmerman was quoted in the August issue of Radiology Administrator's Compliance & Reimbursement Insider in an article about hospital provider-based status requirements.
Eric Zimmerman, Health, Reimbursement/Fraud & Abuse
Eric Zimmerman was quoted in the March 2003 issue of Ambulatory Surgery Compliance and Reimbursement Insider in an article regarding recent recommendations from the U.S. Department of Health and Human Services Inspector General regarding Medicare reimbursement for ambulatory surgery centers.
Eric Zimmerman, Health, Reimbursement/Fraud & Abuse
Eric Zimmerman was quoted in the January 20 issue of amednews.com, an online publication of the American Medical Association's "American Medical News," in an article regarding Medicare payments to ambulatory surgery centers.
Eric Zimmerman, Health, Reimbursement/Fraud & Abuse
Eric Zimmerman was quoted in the January 2003 issue of Ambulatory Surgery Compliance and Reimbursement Insider, a publication of Brownstone Publishers, Inc., in an article about the 2003 Outpatient Prospective Payment System Update.
Eric Zimmerman, Health, Health Ventures/Physician Transactions, Reimbursement/Fraud & Abuse
