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.

The Kickback Chronicles, Episode 2

On this week’s episode, HortySpringer attorneys Henry Casale and Hala Mouzaffar take a closer look at the recent conviction of 3 individuals involved in a substance use disorder treatment facility’s scheme to defraud the California Medicaid program out of nearly $18 million over the course of 4 years. This case will have you asking: 

• How many people can be convicted for a company-wide scheme?
• What causes so many people to participate in a fraudulent scheme?
• And who has to pay back all that money? 

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

Over the years, the Department of Justice has increasingly cracked down on fraudulent billing and kickbacks provided to healthcare providers. Despite nearly $2 billion in recovery of illegal funds every year, providers continue to disregard these laws thinking their actions will go undetected.  

On this inaugural episode, HortySpringer attorneys Henry Casale and Hala Mouzaffar dive into a recent case involving a mobile x-ray provider, where a jury had to consider:

•  Can you bill dead patients and get away with it?

•  Does it matter that Medicare paid for fraudulent claims for years?

•  What are the repercussions of these kind of violations? 

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

On November 5, 2021, CMS issued an interim final rule requiring hospitals and other facilities subject to Medicare Conditions of Participation to adopt a process or plan for vaccinating all eligible staff by December 6, 2021. Staff must be fully vaccinated by January 4, 2022. This not only applies to employees but also medical staff members, trainees, independent contractors, and others. 

HortySpringer attorneys Dan Mulholland and Nick Calabrese break down the new regulation for you and tell you what you need to do NOW to get ready for compliance. Aside from explaining the new rule, the podcast discusses: 

·  What happens if you don’t comply? 

·  Can you ask for a waiver from CMS? 

·  How should you handle requests for medical and religious exemptions? 

·  How do you enforce your policy if independent members of the medical staff don’t comply? 

·  The lawsuit filed by 10 states on November 10 seeking to enjoin the regulations.

Listen now to this episode to learn the latest about what is clearly the hottest topic in health care today!  

This podcast summarizes the requirements in OSHA’s new COVID-19 Emergency Temporary Standard (“ETS”) for employers in the healthcare setting. While the ETS is long and detailed, some healthcare settings are exempt from its requirements. Join HortySpringer attorneys Dan Mulholland and Philip Zarone to learn what healthcare employers must do to comply and where they can turn for additional information.    

Houston, do we have a problem?

Join HortySpringer attorneys Dan Mulholland and Nicholas Calabrese as they explore the rules and risks of mandatory vaccination programs for hospital employees, including a discussion of the Houston Methodist Hospital vaccination program case.

The OIG and the Courts have long taken the position that a person who pays an alleged kickback can be sent to prison if the government can prove that merely “one purpose” of the payment of the kickback is to induce the referral of business that is paid for, in whole or in part, by a federal healthcare program.  But what about the recipient of the kickback?  What must the government prove in order to convict the recipient of the kickback?  In a case of first impression, a federal circuit court’s answer to this question is nothing—the recipient’s intent is irrelevant. 

Join HortySpringer attorneys Dan Mulholland and Henry Casale to find out why the court ruled the way that it did and why this decision will make it even easier for the government to enforce this criminal statute that it was before the decision.