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Ober|Kaler Health Law Alert - Summer 2002




In this Issue

From the Chair

Guide to Terms

Ober|Kaler in Print

OIG Activity
Final Ambulance Restocking Safe Harbor

OIG Advisory Opinions

Long Term Care
Medicaid Nursing Facilities: Prepare To Be Audited

Long Term Care Industry Still a DOL Target

Pharma
Pharmaceuticals Adopt Code of Ethics for Physician Marketing

Durable Medical Equipment
Reprocessing Single-use Devices: Regulatory Implications

Reimbursement
PPS Proposed for Long-term Care Hospitals

Provider-based Rules: Changes and Delays

CMS Proposes Rule for Repaying Overpayments

CMS Expands "Incident-to" Relationships

Final Clinical Lab Rules Published

BIPA's Impact on Administrative Appeals Process

MSP Data Collection Requirements Relaxed Further

EMTALA
Proposed EMTALA Changes Offer Relief

False Claims Act
Qui Tam Hostages: Set My Provider Free

Circuit Court Split: What Constitutes a "Person" Under the FCA?

Medical Center's Lease Payments Are Fair Market Value

Court Says "No" to FCA Quality of Care Case

Enforcement
Staying the Course: Guiding Your Company Through a Fraud Investigation

Tax-Exempt
IRS Cracks Open the Door for Consortium Organizations

Business
Single-Member LLCs: Use Caution When Opening

Antitrust
First Antitrust Advisory Opinion on Clinically Integrated Physician Networks

Employment Report
Supreme Court Weighs in on Application of FMLA

NLRB: Physicians and Nurses Are Not Always "Supervisors"

 

From the Chair

Sandy Teplitzky, Ober|Kaler Health Law Group ChairAlthough we continue to await the publication of the Phase II Stark II final regulations, the health care industry has, in the meantime, been affected by many other recent developments. Perhaps first and foremost, the current state of the U.S. economy is placing pressures on health care providers. There also appears to be no let-up in the pressure felt under the administrative and regulatory requirements imposed by federal and state governments.

This issue of the Health Law Alert addresses a number of developments in the reimbursement arena. We also discuss the most recent developments relating to the federal False Claims Act, which is more and more becoming the provision of choice for federal prosecutions, not to mention the significant increase in qui tam relator cases. In this regard, we also include an article intended to provide guidance to those who find themselves subject to a federal fraud investigation.

As is our custom, we provide analyses of several recent OIG advisory opinions with this issue. In addition, this issue includes an analysis of the first antitrust advisory opinion relating to clinically integrated physician networks which, perhaps, signals a new opportunity, if not simply increased flexibility, for physicians who increasingly find it difficult to "go it on their own." Finally, we include a discussion of the final ambulance restocking safe harbor, perhaps putting that most "controversial" issue to rest.

We hope that you are enjoying your summer. As always, we appreciate receiving any comments or suggestions regarding this or future issues of our Health Law Alert.

Sandy Teplitzky, Department Chair

Copyright© 2002, Ober, Kaler, Grimes & Shriver