Ober, Kaler, Grimes & Shriver, A Professional Corporation  
Ober|Kaler Health Law Alert - Summer 2001




In this Issue

From the Chair

Welcome

Guide to Terms

Ober|Kaler in Print

OIG Activity
OIG Questions Some Business Consultant Practices

Self-disclosure Helps Providers

OIG Advisory Opinions

HCFA Developments
Physician Supervision Levels for Diagnostic Testing

Department of Justice
DOJ Continues Focus on Health Care Fraud

Reimbursement Issues
Medicare Reimbursement May Be Available for Post-12/97 CHOW Losses

Final Rule Addressing Nursing and Allied Health Education Costs

Proposed Payment Policy for Clinical Psychology Training Programs

Long Term Care
New Nursing Home Revisit Policy

Pharma
Implementation of PDMA Delayed

Maryland Enacts Prescription Drug Relief for Seniors

Tax
IRS Guidance on Management Service Agreements Involving Bond-financed Space

New IRS Guidance on Joint Ventures a Trap for the Unwary?

IRS on Charity Care Back to the Future?

False Claims Act
Fifth Circuit Rules Qui Tam Provisions Are Not Unconstitutional

Ninth Circuit Analyzes Excessive Fines Clause

Courts Require Qui Tam Relators to Plead with Specificity

GAO Praises DOJ's Oversight of FCA Guidance

Litigation and Dispute Resolution
Pleading with Prosecutors: The View from the Other Side

PATH: OIG to Decide Whether Carrier Guidance Was Clear

Antitrust
Denying Physicians Access to Patients

Intellectual Property
Hot Health Care Privacy (Not HIPAA) Issues

Physician Focus
Dispensing Drug Samples and Starter Kits

Employment Report
Employer Liability for Harassment by Patients/Residents

 

From the Chair

Sandy Teplitzky, Ober|Kaler Health Law Group ChairWelcome to the summer issue of our Health Law Alert. Perhaps the most striking development since our spring issue relates to CMS, the agency formerly known as Prince — I mean — HCFA. It is our understanding that the change in name is intended to accurately reflect the nature of the agency and its role in today’s health care delivery system. Only time will tell whether the change in name signals a change in direction or mission. However, given that CMS is an acronym for the Centers for Medicare & Medicaid Services, I question how the agency has already lost one of the Ms.

This issue of the Health Law Alert follows our past practice of summarizing as many different developments as possible and placing them in a useful context for our readers. Thus, we address the recent activity of the OIG, CMS, and the DOJ. Further, we address issues relating to reimbursement, long term care, tax, antitrust, and other matters of importance to our health care clients. This issue takes a breather from HIPAA, but addresses other "hot health care privacy issues."

With this issue, we introduce a column focusing on the physician practice setting. The new column, "Physician Focus," which will be a regular feature in this and future issues of the Health Law Alert, will provide pointers and guidance on issues of particular relevance to physician practices. We hope that our physician practice readers will be as pleased as we are with the introduction of the "Physician Focus" column.

In light of recent federal and state enforcement initiatives, we are also introducing a series of documents designed to provide you with basic guidelines for action in case the government should look your way. We hope the documents will be valuable reference tools should you ever need them, although we hope that you never do. However, since we generally understand the distinction between real life and fantasy (for example, the characters in the movie Shrek are not real), we want you to be prepared in any event. The first two documents, which are enclosed with this issue, are entitled "What To Do When the Government Subpoena Arrives" and "All You Need to Know About Search Warrants (Though You Hope You Never Need to Know)." The third document in this series will provide guidance for employees "when the investigator arrives" and will be included with our next issue. These documents are not intended to provide all of the details that must be attended to in these events, but rather are intended to provide a general framework for action at a time when anxiety levels will no doubt be high. Further, addressing these issues when you are not in a crisis mode allows you to better evaluate whether the guidelines will be helpful for you and your organization in the future. The documents are laminated so that they can be filed away or placed on a bulletin board while you don’t need them but can withstand being handled when you do need them. We certainly welcome your thoughts and comments regarding any of these documents.

Finally, many of you have come to know Nathan Hartland of our Department. Although Nathan’s official title has been "paralegal," he has been much more than that for us and for our clients. Nathan is beginning law school at the University of Pennsylvania this fall and although we question his judgment in deciding to go to law school, we wish him the best and hope that he will return to the Ober|Kaler family.

As always, please feel free to forward any comments or suggestions regarding this or future issues of the Health Law Alert.

Sandy Teplitzky, Department Chair

Copyright© 2001, Ober, Kaler, Grimes & Shriver