I had the opportunity to attend the 18th Annual Biotech Conference on February 16-17, 2009 in Raleigh hosted by the Council for Entrepreneurial Development (“CED”).  CED did an incredible job of assembling an extremely high-profile and sophisticated agenda of speakers for the conference.  Among the marquee names in attendance were North Carolina Governor Beverly Perdue, [...]

On January 22, 2009, the Centers for Medicare and Medicaid Services (“CMS”), in its Frequently Asked Questions concerning physician self-referral, stated that “under certain circumstances, a hospital may use a per-use or percentage-based formula to compensate a physician-owned lithotripsy partnership that provides a lithotripter and skilled technician to the hospital on an “under arrangements” basis [...]

The American College of Emergency Physicians (ACEP), the nation’s largest medical society representing more than 22,000 emergency doctors, said this week that the University of Chicago Medical Center is “failing in its obligation to treat emergency patients, citing drastic reductions in in-patient beds for emergency patients”. See http://www.acep.org/pressroom.aspx?id=44294. With additional plans to cut emergency room [...]

  Disease charities such as Cystic Fibrosis Foundation, CHDI Foundation and Juvenile Diabetes Research Foundation, in an effort to increase the rate at which new drugs and disease treatments are developed, approved and available to patients, have entered the world of venture capital. A successful $76 million partnership between Cystic Fibrosis Foundation and Vertex Pharmaceuticals [...]

On February 12, 2009 the Internal Revenue Service (“IRS”) issued its final report on non-profit hospital community benefit and executive compensation practices. This final report is the culmination of a 3 year effort by IRS to assess the amount of community benefits actually conferred by non-profit, tax-exempt hospitals as well executive compensation levels. IRS began gathering information [...]

On February 6, 2008, the Centers for Medicare and Medicaid Services (CMS) announced that the bid protests to the recovery audit contractor program (RAC) program had been settled and the RAC implementation could proceed. The RAC program, authorized by Congress in the Medicare Modernization Act of 2003 and made permanent in the Tax Relief and [...]

Last week the New Jersey Legislature approved a final bill that would amend the State’s existing physician self-referral statute in order to provide greater clarity in the area of ambulatory surgery center referrals and to make several other significant changes to the way surgery centers and office-based surgery are regulated under New Jersey law. The bill [...]

The January 2009 edition of the North Carolina Healthcare Report is now available. Please click here. document.getElementById(“post-428-blankimage”).onload();

Directors have always been subject to a duty of loyalty and a duty of good care in the discharge of their duties as directors.  In North Carolina, directors are also subject to a duty of good faith. Generally, the duty of loyalty requires that a director or manager must discharge his or her duties in [...]

The first two issues of NC Legislative HealthWatch are now available free of charge upon request through NC Healthcare Report. If you would like to receive your complimentary issue, please contact Harry Kaplan of McGuireWoods Consulting at hkaplan@mwcllc.com. You can reach NC Legislative HealthWatch at: www.nchealthwatch.com.  A preview of the first issue is after the [...]

  On January 30, 2009 the United States Court of Appeals for the District of Columbia overturned a district court decision and held that Medicare claims are exempt from disclosure under the Freedom of Information Act (“FOIA”).[1]  Consumers’ Checkbook, Center for the Study of Services (“CSS”) had sought disclosure of Medicare claims by physicians in [...]

On January 12, the Ninth Circuit Court of Appeals affirmed a California physician’s 180-month prison sentence for defrauding the Federal Medicare and California State Medi-Cal programs.  The physician, Aziz F. Awad, was found guilty of illegally billing Medicare and Medi-Cal for certain respiratory services that were in many cases not medically necessary, not properly coded, [...]

A federal appeals court recently reversed and remanded a district court decision dismissing a False Claims Act qui tam claim after finding that an arrangement by and between a hospital and anesthesia group violated the Stark Act and the Anti-Kickback Statute (2009 WL 129888, Jan. 29, 2009)..   In the Third Circuit decision, Dr. Kosenske [...]