Historically, peer review was limited to the review of practitioners’ clinical care for hospital patients.  However, with health care entities providing more clinical services on an outpatient basis and the increase in employed physicians by hospital affiliated entities, there has been significant interest in developing outpatient peer review processes.  But, before moving forward with such a project, there are a number considerations that groups have to evaluate.  For example, the structure that is used for hospital peer review processes usually isn’t required for outpatient peer review.  A more streamlined process is often appropriate and permits groups to make the best of their limited resources.  Also, some state peer review statutes may not extend protections to outpatient peer review.  Therefore, other options for protection need to be considered.  During The Brave New World of Ambulatory Peer Review podcast, Ian Donaldson and Charlie Chulack will touch on these topics and more to assist you in designing your outpatient peer review process.

It’s a new year and there have been several new developments on the fraud and abuse front. The Department of Justice has a new division that will be focusing specifically on fraud. Given the recent activities of the DOJ and the OIG, health care organizations are sure to be in the crosshairs of government scrutiny. Among other things, provider enrollment procedures are likely to tighten up and take longer. And the enforcement agencies and whistleblowers continue to bring False Claims Act cases based on the Stark Law, although the constitutionality of the qui tam provisions of the FCA is being challenged in the Courts. 

Join Dan Mulholland and Henry Casale for this informative update in which they will review these developments and suggest some things you can do to minimize compliance risks in the upcoming months.

HortySpringer attorneys Henry Casale and Hala Mouzaffar discuss how a Ph.D. holder took the title “Doctor” a little too far. Listen now to this episode of The Kickback Chronicles to see what you can learn from the misfortune of others.

On this week’s episode, HortySpringer attorneys Henry Casale and Hala Mouzaffar discuss how a home health agency used unlicensed foreign medical graduates to “assist” physicians in providing services. Listen now to this episode of The Kickback Chronicles to see what you can learn from the misfortune of others.

All too often, a hospital’s response to peer evaluation, especially when there is negative information about the physician, is “name, rank, and serial number.” While this approach may be quick and easy, and feels like it is risk free, it may not be for the patients. The “speak no evil” approach compromises the ability of the hospital on the receiving end of the response from properly credentialing the applicant. 

Join us for episode two of Crash Course Credentialing, as HortySpringer attorneys Susan Lapenta and Lauren Massucci explore how you can share your concerns about a problem physician and protect yourself at the same time and most importantly, protect patients.

The Board is not just a rubber stamp. In Crash Course Credentialing, our new series on the Health Law Expressions Podcast, HortySpringer attorneys Susan Lapenta and Lauren Massucci explore how involved the Board should be in the credentialing process and the information that it should know in order to satisfy its legal obligations. 

On this week’s episode, HortySpringer attorneys Henry Casale and Hala Mouzaffar dive into how lavish speaking events cost a Pharmaceutical Manufacturer a whole lot more than what they bargained for.  

Listen now to this episode of The Kickback Chronicles to see what you can learn from the misfortune of others.

In this episode, HortySpringer attorneys Henry Casale and Hala Mouzaffar look at how a hospice provider frauded millions out of the Medicare program by concealing their true billing intentions. Listen now to this episode of The Kickback Chronicles to see what you can learn from the misfortune of others.

HortySpringer attorneys Henry Casale and Hala Mouzaffar look at how a physician was excluded from participation in all federal health care programs simply due to his position as Medical Director of a Pharmaceutical Manufacturer. Listen now to this episode of The Kickback Chronicles to see what you can learn from the misfortune of others.

On this episode, HortySpringer attorneys Henry Casale and Hala Mouzaffar look at what happens when an OIG Advisory Opinion on pharmaceutical subsidies turns into a court battle over the language of the Anti-Kickback Statute.  

Listen now to this episode of The Kickback Chronicles to see what you can learn from the misfortune of others.