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»  Posts By   February 2014 

DOJ Recovers $3.8 Billion in 2013 for False Claims Act Violations Reinforcing Need for Health Care Providers to Maintain Compliant Practices

In 2013, the Department of Justice recovered $3.8 billion under False Claims Act, the bulk of which stemming from claims for health care fraud. The Obama Administration has been more aggressive in pursuing qui tam cases than previous administrations, and as a result, recovered over $2.9 billion from whistle blower lawsuits (while whistle blowers collected $345 million). The fact that the bulk of these recoveries ($2.6 billion) were for health...

Is Your Practice Compliant with the HIPAA Final Rule?

On January 17, 2013, the U.S. Department of Health and Human Services (HHS) issued a new final rule (“Final Rule”) which requires covered entities, a category that includes medical practices, ASCs, ancillary providers, and pharmacies (“Covered Entities”), to significantly modify both their HIPAA compliance plans and agreements with entities with which they conduct business (“Business Associates”). Covered Entities should be aware that the compliance deadline was September 23, 2013; any...

Medicare Advantage Conflict with United Healthcare Moves to Mediation

In a case that can affect physicians across the country, a federal appeals court in New York City directed United Healthcare and two Connecticut Medical Societies to participate in mediation in an attempt to settle a lawsuit that arose after United Healthcare unilaterally terminated more than two thousand physicians from its Medicare Advantage network in 2013 through a contract amendment. Previously, a federal district court in Connecticut granted a temporary...

The OIG 2014 Work Plan – a Harbinger of Regulatory Activity in the Coming Year

Each year the Office of the Inspector General (OIG) for the US Department of Health and Human Services (HHS) publishes its work plan (Work Plan), affording healthcare providers that bill Medicare and Medicaid a looking glass into future OIG activity. One of the primary roles of the OIG is to protect the integrity of HHS programs, including Medicare and Medicaid, and to detect and prevent fraud, waste, and abuse. The...

Imprimis Announces Acquisition of N.J. Compounding Pharmacy in Latest Wave of Effort to Convert Compound Formulas into FDA Approved Drugs

Imprimis Pharmaceuticals announced this week an agreement to acquire New Jersey-based compounding pharmacy – Pharmacy Creations LLC. Imprimis, which is a pharmaceutical company focused on the development and commercialization of proprietary compounded drug formulations, has been in the process of seeking out and acquiring compounding pharmacies for the purpose of turning formulas used by compounding pharmacies into finished drug products, available for broad marketing and sale. Imprimis had already acquired...
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