Lisa C. Keenan

Despite the numerous pivots in the Department of Justice's focus over the past year, one priority remains constant: identifying “waste, fraud, and abuse, including health care fraud and federal program and procurement fraud that harm the public fisc.” Indeed, the Criminal Division identified this as its No. 1 priority last year. Subsequently, DOJ announced the formation of a DOJ-HHS False Claims Act Working Group signaling a coordinated, cross-agency approach with the Department of Health and Human Services (HHS) to rooting

The Office of Inspector General (OIG) and the Centers for Medicare & Medicaid Services (CMS) jointly published final rules that expand upon and modify regulatory safe harbors and exceptions to the Anti-Kickback Statute and the Ethics in Patient Referrals Act (the Stark law), respectively. This article will address each rule and focus on the exceptions and safe harbors applicable to value-based arrangements. Stark Law Final Rule: Value-Based Arrangements The Stark law prohibits physicians from referring patients to receive certain designated health services

On March 30, 2020, the Secretary of the Department of Health and Human Services (HHS) acted pursuant to the declared COVID-19 public health emergency and granted blanket waivers—effective March 1, 2020—of certain provisions of Section 1877(g) of the Social Security Act, otherwise known as the Physician Self-Referral (or “Stark”) Law. The Stark Law prohibits a physician from making referrals for certain designated health services payable by Medicare to an entity with which he or she (or an immediate family member) has

On March 23, 2020, the Maryland Secretary of Health issued an Order and Directive (the “Directive”) that addresses a number of different health care issues for the prevention and control of COVID-19. One area addressed is the postponement of elective surgery. The Directive orders all Maryland licensed hospitals, ambulatory surgery centers and other licensed health care facilities to cease all elective and non-urgent medical procedures effective as of 5 p.m. on Tuesday, March 24, 2020, and to not permit any

As of March 18, 2020, Maryland regulators have temporarily suspended certain child care licensure requirements in order to expand access to child care for school-age children of “emergency personnel.”  The state has identified “emergency personnel” as employees who work in hospitals and first responders such as fire, police, doctors and nurses.  The State Superintendent of Schools for the Department of Education (the state agency responsible for licensing child care centers) took this action in response to the Executive Order issued

CMS issued guidance on March 9, 2020, that allows hospitals to set up alternative screening sites on campus and at off-campus, hospital-controlled sites.  The guidance provides the following options:  Alternative Screening Sites On-Campus – The guidance states that the medical screening exam (MSE) that hospitals are required to provide to every patient that presents to the emergency department (ED) is not required to take place in the ED; hospitals may set up alternative sites on campus to perform the MSEs, including

On March 13, 2020, President Trump declared a national state of emergency as a result of the coronavirus (COVID-19) outbreak.  Regardless of the intensity of the emergency from COVID-19 in a particular area, the President’s declaration allows the federal government, under Section 1135 of the Social Security Act, to waive many of the day-to-day requirements imposed on health care providers by Medicare, Medicaid and the Children’s Health Insurance Program. Additionally, health care providers now have an opportunity, either collectively or