Ober, Kaler, Grimes & Shriver, A Professional Corporation  
Ober|Kaler Health Law Alert - Spring/Summer 2003




In this Issue

From the Chair

Congratulations

Guide to Terms

Ober|Kaler in Print

OIG Activity
Ober|Kaler Prompts OIG Response to Medical Malpractice Insurance Crisis

Temporary Okay for Local Transportation Programs

OIG Advisory Opinions

CMS Developments
CMS Clamps Down on Outlier Payments

Long Term Care
Ergonomics Guidelines for Nursing Homes

Nursing Home Arbitration Agreements

Criminalization of Nursing Home Abuse and Neglect

Compliance
OIG Issues Ambulance Compliance Guidance

Privacy
Interpreting the Privacy Rule for Your Organization

Organized Health Care Arrangements Under HIPAA

Reimbursement
Proposed Appeals Procedures

Revised Incident-to Carriers Manual

Self-Referral
"Set-in-advance" Definition Delayed

Recent Settlements Resolve Self-referral Allegations

FCA Claim
FCA Claim Based on Kickbacks is Rejected

Antitrust
Teaming Up Against Managed Care: Antitrust Considerations

Employment
When Duty Calls

 

From the Chair

Sandy Teplitzky, Ober|Kaler Health Law Group ChairIt gives me great pride to announce that 2003 represents the 100th anniversary of our firm. In that 100 years, we have grown from a small, general practice firm with a specialty in admiralty to one of the largest firms in Maryland, and certainly one of the largest and most respected health law practices throughout the country.

I am also pleased to note that during the first week of January, Robert "Bobby" Ehrlich was sworn in as the Governor of Maryland. Bobby is a former associate and partner with Ober|Kaler and is the second attorney from this firm to serve as Governor of Maryland. (The first was Governor Albert Ritchie, who served a 16-year term from 1920 to 1935.) Since starting with this firm out of law school, Bobby has served with distinction in the Maryland State Legislature, in the United States House of Representatives, and now in the Maryland State House. We wish him continued success and pledge to work with him during his administration.

As long as I am making announcements, I am also pleased to inform you that Janet DiAntonio and John Lessner were elected as principals of the firm effective January 1, 2003. Both Janet and John joined us from other endeavors and have served to solidify our ability to provide a full range of services to our health care clients.

The Health Law Alert reports on developments throughout the health care industry and the agencies which administer and enforce the applicable federal, state, and local laws. This issue includes a development which directly related to our efforts to serve our clients. Specifically, we report on a letter we received from the OIG relating to creative efforts by health care providers to address the existing physician medical malpractice insurance crisis. Although the letter responds to a particular fact pattern, it establishes a set of guidelines which should be helpful in developing proposals to address this crisis throughout the country.

With the effective date of the HIPAA privacy regulations now upon us, we continue our efforts to report new developments and to provide clarification and guidance on the myriad of complicated and complex issues facing all health care providers. We also continue to report on the development of compliance program guidance by the OIG, and specifically, address the guidance issued for ambulance companies.

I also want to take this opportunity, because I have not done so in a long time, to personally thank Michele Vicente for her untiring efforts in the development, editing, and formatting of our Health Law Alert. The response we receive from our friends and clients to the various issues of the Health Law Alert reaffirms our view of their value, and this could not be achieved without Michele's persistence and commitment to excellence.

Sandy Teplitzky, Department Chair