Dykema Gossett PLLC

Homeostasis: Health Care Law Blog

Posts by Eric S. Klein

Contributors

Photo of Homeostasis: Health Care Law Blog Eric S. Klein
Member
eklein@dykema.com
248-203-0891
View Bio

Showing 3 posts by Eric S. Klein.

The New Anti-Kickback Statute in Town

On October 24, 2018, Congress enacted a new federal anti-kickback statute as part of its effort to combat the opioid epidemic. Congress established the Eliminating Kickbacks in Recovery Act of 2018 (“EKRA”) as part of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act of 2018. EKRA establishes criminal sanctions (up to $200,000 fine and/or 10 years imprisonment) for each kickback violation. Unlike the anti-kickback statute set forth in 42 U.S.C. § 1320a-7b(b) (“AKS”) that only pertains to federal health care programs (e.g., Medicare and Medicaid), EKRA applies to any “health care benefit program” and, thus, extends to services payable by both a federal health care program and a commercial insurer.  Read More ›

Hospice Providers Take Note: OIG Highlights Compliance Vulnerabilities in the Medicare Hospice Benefit

For a number of years, the Office of the Inspector General (OIG) of the U.S. Department of Health and Human Services has published concerns about the quality of Medicare-certified hospice providers and about fraud and abuse in the Medicare hospice benefit program. On July 31, 2018, the OIG consolidated its concerns into a portfolio “Vulnerabilities in the Medicare Hospice Program Affect Quality Care and Program Integrity: A Portfolio” (OEI-02-16-00570). While neither the U.S. Centers for Medicare and Medicaid Services (CMS) nor the National Hospice and Palliative Care Organization agree with all of the OIG’s concerns or recommended fixes, the OIG is steadfast. Hospice providers can expect continued OIG scrutiny of both industry and individual provider practices, as well as continued OIG effort to effect structural change in the Medicare hospice benefit to improve program integrity. Read More ›

CMS Clarifies Role and Responsibilities of Hospice Medical Directors and Other Hospice Physicians

After a series of CMS surveys caused confusion in the hospice industry regarding the role and responsibilities of the medical director, CMS Region V issued much-needed clarification. CMS Region V, which covers hospices in the states of Illinois, Indiana, Michigan, Minnesota, Ohio, and Wisconsin, clarified that: Read More ›