“Incident to” billing is widely practiced, and its regulations are generally well-known. But one Arizona physician recently found himself pleading guilty in federal court on April 3, 2024, to a criminal healthcare fraud charge over improperly billing Medicare and private payors for healthcare services that failed to abide by the rules over “incident to” billing. This blog post explores how this lack of compliance resulted in such a serious criminal consequence.

Continue Reading Arizona Physician Pleads Guilty to Healthcare Fraud over Improper “Incident To” Billings

We are proud to announce a much-needed addition to Husch Blackwell’s lineup of podcasts. Last week, we launched False Claims Act Insights, a new podcast devoted to exploring issues relating to False Claims Act (FCA) investigations and litigation. The show is hosted by Jonathan Porter—a partner in our firm’s White Collar, Internal Investigations & Compliance practice group and former Assistant U.S. Attorney for the Southern District of Georgia—and will feature prominent guests who dive into the complexities of FCA enforcement and compliance.

The U.S. Department of Justice recently published its annual release of FCA-related information, boasting that its 2023 results were the “Highest Number of Settlements and Judgements in History.” In sum, the Department achieved settlements and judgments exceeding $2.68 billion during the last fiscal year. As FCA enforcement continues to increase, we are pleased to provide subscribers to Healthcare Law Insights a go-to resource for perspectives on FCA-related news and developments.

So, you’ve received a third-party subpoena. Now what? A third-party subpoena is the procedural mechanism that allows parties in litigation to obtain evidence from non-party individuals and/or entities. For federal cases, Federal Rule of Civil Procedure 45 governs this process. Rule 45 outlines specific procedures that litigants must follow to serve a subpoena seeking documents and/or testimony properly. The Rule also provides protections non-parties can use to alleviate their burden in producing responsive documents. Most states have their own rules that govern non-party discovery that often, but not always, mirror Rule 45.

Continue Reading Five Important Things to Consider When You Receive a Third-Party Subpoena

On October 8, 2023, Governor Gavin Newsom signed Assembly Bill 1286 (AB 1286), a sweeping pharmacy measure with several components aimed at promoting patient safety. Chief among AB 1286’s mandates is a new law requiring that community pharmacies report outpatient medication errors to the California Board of Pharmacy. But beyond the mandatory reporting requirement, AB 1286 contains various other important provisions governing the practice of pharmacy in California.

Continue Reading California Enacts First-in-Nation Pharmacy Medication Error Reporting Law

Most experienced False Claims Act (FCA) practitioners are all too familiar with the statutory provision requiring defendants to pay whistleblowers’ attorneys’ fees at the end of FCA cases. What is less commonly known is the provision that grants defendants their attorneys’ fees in certain circumstances.

One whistleblower learned about that provision the hard way, when on March 14, 2024, a Mississippi federal judge ordered that he pay over $1 million to cover the defendants’ attorneys’ fees, following grant of summary judgment to defendants in what the judge labeled a “frivolous” qui tam. This blog post looks at the case that led to such a large attorneys’ fees award and considers the types of cases in which these efforts are wise.

Continue Reading Federal Judge Orders Whistleblower Who Filed a “Frivolous” Qui Tam to Pay Over $1 Million for Defendants’ Attorneys’ Fees

U.S. Senators Angus King (I-ME) and Marco Rubio (R-FL) recently introduced a bill addressing cybersecurity protections and oversight in the healthcare industry. The Strengthening Cybersecurity in Health Care Act, introduced on February 8, 2024, aims to bolster a vulnerable and often-targeted industry against cyberattacks. The proposal follows a number of significant cyberattacks on healthcare organizations in recent years; Senator King noted that approximately 133 million people, or nearly one in three Americans, had their personal information compromised in 2023 alone.

Continue Reading Cybersecurity in Healthcare: Pending Bill Calls for Tougher Protections

In the United States, mental health (“MH”) and substance use disorder (“SUD”) (collectively “MH/SUD”) have continued to represent areas of intense concern. During the COVID-19 pandemic, the MH struggles of essential workers and health care professionals were pushed to the forefront. However, issues related to MH/SUD have continued to escalate.

Continue Reading Mental Health Parity and Addiction Equity Act: Comprehensive Final Rule Expected in 2024

Every year, I look forward to the SXSW Interactive Health & MedTech Track, which showcases and explores the future of healthcare technology being created by innovators, entrepreneurs, and tech enthusiasts. This year is no different!

Continue Reading Avoiding the Landmines on the Path to HealthTech Innovation

The recent, rapid advancement of the development of artificial intelligence and machine learning (AI) has revolutionized various industries. It is unsurprising then, that at this year’s South by Southwest Conference (SXSW), there are more AI related panels than any other subject — by far.

Continue Reading Closing the Gap: Medical Device Innovation, Frontline Healthcare Workers, and the Role of AI
Provider Relief Fund Update

Corporate defendants are frequently faced with a quandary—is the company’s highly sophisticated professional employee simply a fact witness or does their anticipated testimony propel them into the world of expert discovery? The individual knows the business inside and out, and typically has a comprehensive understanding of the entire industry, but the legal parameters of whether they qualify as a lay witness or expert witness in this context is not always clear. And either designation presents potentially significant risks. Companies must proceed with caution and consider the following before proceeding.

Continue Reading A Non-Expert with Expertise: Navigating the Risks and Rewards of Testimony from Highly Sophisticated Professional Employees in Federal Court