On June 9, 2015, the OIG issued a new Fraud Alert, cautioning physicians who enter into compensation arrangements such as medical directorships to ensure that the arrangements reflect fair market value for bona fide services that the physicians actually provide. The OIG reiterated that a compensation arrangement could violate the Anti-kickback
Many employers in the past have offered employees cash to reimburse the purchase of an individual policy from a private insurance carrier or on the Marketplace (aka the Exchange) or for other substantiated medical expenses in place of employer sponsored group health coverage. However, the federal government has recently taken the
During the 2014 Legislative session, the Louisiana Legislature enacted the Louisiana Telehealth Access Act (the “Act”), La. R.S. 40:1300.401 et seq. In the Act, the Louisiana Legislature declared telehealth to be “extremely valuable” because it enhances access to care, promotes cost-effective delivery of care, and could improve health outcomes.[1] The
On February 25, 2015, the Supreme Court of the United States issued an opinion against the North Carolina Board of Dental Examiners (the “NC Board”) finding that the NC Board had violated federal antitrust law by issuing cease and desist letters to non-dental licensed persons who performed teeth whitening services. The
The OIG issued Advisory Opinion 15-3 to address an arrangement proposed by a licensed offeror of Medicare Supplemental Health Insurance (“Medigap”) policies (the “Requestor”), in which the Requestor would indirectly contract with a preferred hospital organization (“PPO”) having contracts with a national network of hospitals (the “Network Hospitals”) for discounts on
The latest OIG Advisory Opinion, issued February 9, 2015, addresses the issue of sharing federal health care program payments with an excluded practitioner. While federal statutes prohibit payment by any federal health care program, including Medicare or Medicaid, for items or services furnished by an excluded person or furnished at the
The Louisiana Department of Health and Hospitals (“DHH”) adopted provisions to establish the Recovery Audit Contractor (“RAC”) Program, effective November 20, 2014, as required by the Affordable Care Act. The new RAC program provides yet another mechanism by which DHH, through its contractors, can conduct post-payment audits of claims submitted by
On September 20, 2014, the Department of Health and Hospitals (“DHH”) published its notice of intent to promulgate a rule to continue the provisions of a March 20, 2014 Emergency Rule regarding the prohibition on provider steering of Medicaid recipients to select a particular health plan. DHH had previously promulgated an
To participate in the Louisiana Medicaid Program, providers have been required to ensure that their current and potential employees, contractors and other agents and affiliates were not excluded from participation in the Medicare or Medicaid Programs. Providers have been instructed to check the Department of Health and Human Services’ Office of
The Louisiana Board of Pharmacy has revised the rules on access to patient information maintained by the Prescription Monitoring Program (“PMP”). Historically, only persons authorized to prescribe or dispense controlled substances or drugs of concerns could access the PMP. The Board recently revised the PMP rules to now allow a “delegate”