The Joint Commission announced in mid-December that, effective immediately, hospitals could begin reappointing and renewing clinical privileges for practitioners every three years, rather than every two years.  This is nothing new for those hospitals accredited by the DNV, but with this announcement, many hospitals accredited by TJC are considering moving to a three-year appointment period.  Before making this decision, there are several factors that you should evaluate.  For example, what changes will you need to make to your Medical Staff governance documents, does state law permit you to reappoint practitioners every three years (some do not), and are there changes to your peer review process that you will need to make to ensure that patients are protected if a longer appointment term is adopted.  Join Horty, Springer and Mattern attorneys Susan Lapenta and Charles Chulack for this podcast episode that provides the answers to these questions and more!

The Kickback Chronicles, Episode 10

On this week’s episode, HortySpringer attorneys Henry Casale and Hala Mouzaffar turn their focus to telemedicine fraud in the pharmaceutical industry. With help from an industry expert, they take a closer look at some common themes to look for and avoid in the pharmaceutical world. 

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

The Kickback Chronicles, Episode 9

On this week’s episode, HortySpringer attorneys Henry Casale and Hala Mouzaffar dive into the world of telemedicine. The expansion of access to telemedicine services during the COVID-19 pandemic has opened the door to a whole new type of fraud.  Join us as we take a closer look at how the OIG will be identifying and evaluating these types of cases as well as some of the most recent victims of the OIG’s crackdown on telemedicine.    

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

The Kickback Chronicles, Episode 8

On this week’s episode, HortySpringer attorneys Henry Casale and Hala Mouzaffar take a closer look at a recent case involving an alleged kickback scheme between an engaged couple on separate ends of a financial relationship. In what first appeared to be a shut and close case, now remains unfinished. Learn how just two words changed everything.   

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

The Kickback Chronicles, Episode 7

On this week’s episode of The Kickback Chronicles, HortySpringer attorneys Henry Casale and Hala Mouzaffar take a closer look at a recent case involving a woman who just couldn’t get enough of the Department of Justice. While awaiting sentencing for a guilty plea of health care fraud, this week’s schemer got herself involved in yet another Medicaid billing scheme. 

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

The Kickback Chronicles, Episode 6

On this week’s episode, HortySpringer attorneys Henry Casale and Hala Mouzaffar flip the script and examine the government’s investigation tactics when examining fraud cases. As they walk through the process using a recent case, you will get a sense of the resources the government has at its fingertips and just what lengths it will go to prove fraud beyond a reasonable doubt.  

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

The Kickback Chronicles, Episode 5

On this week’s episode, HortySpringer attorneys Henry Casale and Hala Mouzaffar look into the world of fraudulent COVID-19 Vaccination Cards by taking a deeper dive into two recent cases involving forged and fraudulent vaccination cards.  Although fraudulent vaccination cards were the root of these crimes, you’ll be shocked to learn the series of events that led up to charges being filed and the subsequent guilty pleas entered.  

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

The Kickback Chronicles, Episode 4

On this week’s episode, HortySpringer attorneys Henry Casale and Hala Mouzaffar look at the recent guilty plea of the owner and operator of a marketing company that conducted business with medical testing companies. What began as a scheme to defraud Medicare out of funds related to genetic testing, turned into a bigger opportunity at the onset of the COVID-19 pandemic. This case will show the government’s crackdown on fraud in connection with COVID-19 and leave you wondering if this is just the tip of the iceberg. 

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

Hospitals often review and revise their medical staff bylaws and policies to keep up with new developments, but many rarely or ever pay attention to their hospital corporate bylaws.  Corporate bylaws are required to contain provisions required by CMS, the IRS, state licensure agencies, and accrediting bodies, but if they haven’t been updated in a while they may not meet these requirements. 

Corporate bylaws should also compliment and supplement medical staff documents, but if they are inconsistent with medical staff documents it can spell trouble if there is ever a dispute over credentialing or privileging.  HortySpringer partners Lauren Massucci and Dan Mulholland will explore this topic in their current podcast and tell you what you should be looking for when you dust your corporate bylaws off to see what’s in them. 

The Kickback Chronicles, Episode 3

On this week’s episode, HortySpringer attorneys Henry Casale and Hala Mouzaffar look at the recent conviction of the 3 owners of multiple orthotic brace supply companies across Texas. Together they set out to defraud Medicare out of nearly $6.5 million by violating the Anti-Kickback Statute. This case will leave you wondering how you even conceal these payments, and what is the price these owners stand to pay?

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