New OIG Self-Disclosure Protocol

The OIG released an updated self-disclosure protocol this week, about ten months after putting out a call for comments on the old protocol. The new protocol imposes some new burdens on the disclosing entity, such as a shorter timeline for internal investigations and reporting, and higher minimum fines. According to the OIG, the benefits of […]

Accountable Care Organization (ACO) Regulations: First Look

ACO regulations and related federal issuances hit the street last Thursday, after several months of waiting — from CMS, OIG, FTC, DOJ and IRS.  They cover the waterfront, ranging from the central regulation defining the structure and workings of the ACO, to  limited Stark self-referral ban and anti-kickback statute waivers in the fraud and abuse […]

AQC to ACO: As goes Massachusetts, so goes the nation?

About four years ago here in Beantown, survivors of the last big ill-conceived or poorly-executed (depends who you ask) wave of health care management and finance innovation were kicking around for a new approach to aligning payor and provider incentives, focusing on quality and cost containment. To hear Andrew Dreyfus, CEO of Blue Cross Blue […]

Health Care Reform: What Price Progress?

There's a lot of breast-beating going on out there regarding recent "shocking" behavior by many health care provider organizations.  Believe it or not, all across the nation, health care providers are seeking to affiliate/acquire/be acquired in the hopes of creating more efficient, more comprehensive provider networks, which can survive and flourish under new reimbursement regimes […]

David Harlow Keynotes on Health Care Social Media and the Law at Annual Healthcare and the Internet Conference

I attended the 14th Annual Healthcare and the Internet Conference in Las Vegas this week, and gave a keynote presentation entitled: “Health Care Social Media – The Lawyers Don’t Always Say No” in which I discussed the reasons for health care providers to engage with their constituencies via social media — both from a business […]

OIG Issues "Roadmap for New Physicians" – A Guide to Avoiding Fraud and Abuse – and Some Thoughts on its Context

In October, the Office of Inspector General issued a report on Fraud and Abuse Training in Medical Education, finding that 44% of medical schools reported giving some instruction in the anti-kickback statute and related laws, even though they weren't legally required to do so. (As an aside, do we really live in such a nanny […]