A Michigan legislator’s bill, SB 1033, sponsored by Senator Patrick Colbeck, would benefit direct primary care doctors in that State, and the idea may warrant consideration in other States. The purpose of the bill is to provide physicians who convert their practice to a direct primary care model with the…
Little Health Law Blog
Physician Practices: Recent Survey Reviews the Effects of Expanded Patient Access
A well-intended objective of the Affordable Care Act (ACA) is to improve patient access to doctors. Sometimes this objective is artfully stated as “better” access to care, rather than “increased” access to care, perhaps to acknowledge the reality that as more patients become insured via the ACA, there may actually…
September 18, 2014. Kevin Little speaks to physicians. Update on Physician Employment Agreements. InHealth Consulting & Educational Services National Tele-Class Series.
Kevin Little speaks to physicians. Update on Physician Employment Agreements. InHealth Consulting & Educational Services National Tele-Class Series.
Health Care Fraud Report: OIG Alert Regarding Laboratory Payments to Referring Physicians
Clinical laboratory payments to physicians in excess of the fair market value of services provided or that correlate to the volume or value of referrals can constitute health care fraud and trigger very serious civil and criminal penalties. The Department of Health and Human Services’ Office of Inspector General (OIG)…
Affordable Care Act Expansion of Community Health Centers: Endeavoring to Ensure Insurance “Coverage” Equates to Health Care “Access”
A premise of the Affordable Care Act (ACA) is to provide “affordable coverage” to more Americans with the idea being that newly insured individuals and families will have enhanced “access” to quality health care. Whitehouse Policy Snapshot. Particularly important is access to primary care, the means by which millions of…
Health Care Fraud Report: Recent Federal Indictment of Cardiologist for Alleged Overbilling of Medicare
On August 21, 2014, the United States Attorney for the Northern District of Ohio, Stephen D. Dettelbach, together with representatives of the FBI and OIG, announced the indictment of a Westlake, Ohio Cardiologist for alleged health care fraud. The cardiologist is alleged to have overbilled Medicare and private insurers by…
Medicare Issues for Direct Pay and Concierge Practices
The strain of health care reform and third-party-payer bureaucracy will likely continue to push physicians towards non-traditional business models for practicing medicine. This is especially true for non-specialists. As the trend of physicians to find viable practice model alternatives grows, it is widely expected that the number of direct pay…
Medicare Fraud: Federal Strike Force Brings Nationwide Charge Against 90 Individuals
As part of the Centers for Medicare and Medicaid Services’ (CMS) continued efforts to combat Medicare fraud, federal charges were recently brought against 90 individuals across the nation for false billings to Medicare, totaling $260 million dollars. These charges were the result of a collective task force comprising federal, state,…
Healthcare Whistleblower Claims Based on Self-Referral Arrangements
Two federal laws regulate referrals and financial arrangements between healthcare providers and facilities – Stark Law and the Anti-Kickback Statute.1 These laws have recently been at the center of important healthcare whistleblower fraud cases. While both serve the same essential purpose – to eliminate improper financial incentives that interfere with…
July 15, 2014, EfficiencyInPractice publishes article co-authored by Kevin S. Little and Jay D. Brownstein, The Affordable Care Act & Quit Tam Whistleblower Claims
EfficiencyInPractice publishes article co-authored by Kevin S. Little and Jay D. Brownstein, The Affordable Care Act & Quit Tam Whistleblower Claims