Third Circuit Decides Stark Exception Case in Qui Tam Context
The Third Circuit Court of Appeals has rendered a provocative decision in the qui tam case, United States of America ex rel. Ted D. Kosenske, M.D. v. Carlisle HMA, Inc., which opinion was filed on January 21, 2009 and which is available at …
It was the night before Christmas and all through the west, not a physician was conspiring, not even the next. . . On December 24, 2008, the FTC announced settlement of price fixing cases against AllCare IPA, a 500 physician multi-specialty IPA organized as Independent Practice Associates Medical Group, Inc. in Modesto, California…
Pennsylvania’s Department of Public Welfare, which administers the Medical Assistance or Medicaid Program for the Commonwealth, experienced a huge set back in its efforts to curtail the use of annuities in Medical Assistance Long Term Care (MA-LTC) Planning with the recent Weatherbee v. Richman opinion dated January 22, 2009.
The Department contested the conversation of Mr. Weatherbee’s “excess resources”, those above the allowable limit, to an immediate, non-assignable annuity which provided an income stream to his non-institutionalized or community souse. The Department contended that this annuity could be sold on the secondary market and thus converted back into an available resource to Mr. Weatherbee, which resource would need to be spent down before MA-LTC benefits could be granted. The Department relied upon anti-assignment provisions in Pennsylvania law found at 62 P.S. Section 441.6.
The United States District Court for the Western District of Pennsylvania rejected the Department’s argument in ruling on its Motion to Dismiss Mr. Weatherbee’s action for declaratory and injunctive relief. The Court held that the anti-assignment provision in Section 441.6 is preempted by Federal MA-LTC law. Continue Reading Favorable Clarification on Annuity Use in Medical Assistance and Long Term Planning
Any Upside to Downtrodden Markets? Estate Planning has Never Looked Better
As recently noted in the Wall Street Journal (see the following link): http://online.wsj.com/article/SB123249848140700515.html?mod=rss_Tax_Report), a combination of low interest rates and depressed asset values have caused the recent turn of events in the US economy to be one of the best times in history…
In Cole vs. St. James Healthcare, the Montana Supreme Court affirmed the entry of a preliminary injunction against St. James Healthcare. The facts, briefly stated, were that the hospital had undertaken an investigation in a manner that was not authorized by the medical staff bylaws and changed Dr. Cole’s Medical Staff status without following the …
Medicare has announced the January 2009 ASC payment updates. It covers new surgical procedures, new and updated codes for drugs and biologicals, and additional services. The link is attached.
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6323.pdf
You might have a domain name or a pending or registered trademark with the US Patent and Trademark Office. If so, you may be a potential recipient of unsolicited e-mails from alleged Chinese domain name registrar and dispute resolution providers.
Typically, the e-mail states that another company is attempting to register a domain name or…
The Department of Labor has issued new amendments to the Family and Medical Leave Act that are effective January 16, 2009. We will shortly be sending out an explanation of the new regulations and how they may effect you.
However, there is an immediate effect on employers, as the FMLA poster that you are currently displaying…
As required by Section 911 of the Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MMA), CMS is replacing its current claims payment contractors, previously known as Fiscal Intermediaries or Carriers, with new contract entities called Medicare Administrative Contractors (MACs).
The responsibility for paying Medicare Part A and Part B claims is divided into …
A New Jersey Court has awarded $400,000 to a deaf patient who claimed her doctor discriminated against her by refusing to provide an interpreter. Irma Gerena sued Robert Fogari, a Jersey City rheumatologist, under the Federal Americans With Disabilities Act and Rehabilitation Act, claiming violations for refusing to provide to interpreter. This is not a new issue. The …
