100 Great Reasons To Read Blawg Review #100
A quick thanks to the Editor for allowing me the opportunity to host Blawg Review #44 and Blawg Review #97.
"Anything you do to make information more accessible for good, laudable purposes will simultaneously make it more accessible for evil nefarious purposes. People intuitively understand that, and they are worried."Those of us working on health privacy and e-health issues should regularly consider and reassess this principal as we move forward to transform the way health information is collected, stored, used, disclosed and aggregated. Over the years to come health lawyers will play an increasingly important role in the process of addressing legal issues that arise from the concept highlighted by the quote.
In order to further combat health care fraud and abuse, Congress enacted the Deficit Reduction Act of 2005 (“DRA”),
On
According to § 6032, the entity must include this information in its employee handbook. CMS indicates that an entity that does not have an employee handbook is under no obligation to create one. However, CMS does indicate that it is the entity’s responsibility to disseminate the written policies.
All health care entities subject to § 6032 were required to comply with the provisions of § 6032 by January 1, 2007. The penalty for non-compliance is high—health care providers can be excluded from participation in the Medicaid program. In addition, failure to establish and distribute false claims policies could result in false claims exposure. Furthermore, if a false claim action is brought against an entity and the entity is found liable, the entity may have to pay treble damages to the government.
Currently,
If history is any indication,
In the future, it is likely that all entities, whether receiving more or less than $5 million in Medicaid payments, will be required to comply with § 6032’s false claims and anti-fraud policies. Additionally, if § 6032 helps curtail Medicaid spending, fraud, and abuse, it is plausible that Congress will enact similar policies for the Medicare program. Due to the DRA’s employee education requirements and state incentive to create false claims acts, the future holds a strong likelihood of increased false claims investigation and litigation.
Amy L. Rothman is a health care litigation attorney at Flaherty, Sensabaugh & Bonasso, PLLC. For questions, she can be reached at (304) 345-0200.
UPDATE: On March 20, 2007, CMS issued DRA 6032 - Employer Education About False Claims Recovery - Frequently Asked Questions an additional guidance document on interpretation of the new regulations. Additional guidance materials can be found under the State Medicaid Directors Letters section of the CMS website under Final Guidance Regarding Employee Education for False Claims Recovery.
Editor:
I sometimes find it depressing that so many people in our state take at total face value negative results of research and misleading statistics that are quoted in newspapers and elsewhere. Maybe one should check their sources before automatically assuming that the information is totally accurate. I refuse to allow this sort of negative publicity to deter me from giving accolades to deserving individuals who dedicate their lives to teaching and institutions that help prepare our youth so that they have the necessary skills to succeed.
My granddaughter will graduate from Bethany College in May with a degree in chemistry and biology. She has been accepted at all of the medical schools to which she applied. Although she is a bright, self-motivated student, she did not accomplish this feat alone. She was guided with the nurturing support of many professors at Bethany, especially the mentoring of her biology professor, John Burns. I publicly offer my thanks and praise to him and to others at this fine institution who have helped her so much.
I understand very well that all is not perfect in West Virginia, but I hope that people will stop perpetuating the myth that we do not offer our youth the skills they need to succeed in life.
Barbara Hutchison-Smith
Cross Lanes
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