April 25, 2013
On April 1, 2013, the U.S. Court of Appeals for the Sixth Circuit overturned an $11.1 million False Claims Act (FCA) judgment by the U.S. District Court for the Middle District of Tennessee against MedQuest Associates, Inc., a large provider of diagnostic imaging services, and three of its Nashville, TN-area facilities. The decision, which analyzed Medicare regulations concerning conditions of participation and conditions of payment, further clarifies for health care providers that, in the Sixth Circuit’s view and similar to the views of some other circuits, violations of Medicare conditions of participation, absent violations of conditions of payment, are not a basis for FCA liability. Moreover, the decision clarifies the Sixth Circuit’s view that violations of certain Medicare requirements should not be construed as violations of Medicare conditions of payment. Read More
Aug. 14, 2012
The health care community is still digesting the Supreme Court’s much anticipated and surprising decision on the Affordable Care Act (ACA). Chief Justice John Roberts confounded experts on both sides ... Read More
June 28, 2012
In a 5-4 vote, the Supreme Court today upheld the Affordable Care Act in its entirety with the exception that states may opt out of the Act's requirement of expanded ... Read More
Jan. 25, 2012
This article was originally published online at mHIMSS (December 1, 2011). Read More
Oct. 17, 2011
This article was originally published in HBMA Billing e-Newsletter, Vol. 16, Iss. 4 (Jul.-Aug. 2011). Read More