By JENNIFER COLAGIOVANNI, ESQ
Wachler & Associates, P.C.
The pandemic changed the relationship between patients and their healthcare providers, and telehealth use surged during the COVID-19 pandemic. Specifically, Medicare beneficiaries used telehealth services 88 times more often during the first year of the pandemic than in the year prior.  Medicaid and private health plans saw similar growth in the use of telehealth.  With this growth came concerns about the risks of fraud, waste, and abuse. The Office of Inspector General (OIG) for the Department of Health and Human Services (HHS) recently released a toolkit setting forth methods to analyze telehealth claims and identify risks associated with telehealth services in the wake of [Read More]

By ANDREW SPARKS
Dickinson Wright
A recent decision by the Supreme Court clarified the required intent for a defendant to be held liable under the False Claims Act.  According to the Court, the FCA’s scienter requirement refers to a defendant’s knowledge and subjective beliefs – not what an objectively reasonable person might have known or believed.  This ruling removes potential defenses for FCA defendants and makes the dismissal of FCA claims on the basis of scienter much less likely before discovery has been completed.

Background

The consolidated cases involved allegations that two pharmacies defrauded Medicare and Medicaid by selling drugs at a lower rate to the public, while receiving reimbursement at a [Read More]

Lansing Lines is presented in cooperation with MIRS, a Lansing-based news and information service.

Appellate Court Affirms Dismissal Of Suit Challenging MSU Vaccine Mandate

A federal appellate court affirmed this month the dismissal of a lawsuit challenging Michigan State University’s COVID-19 vaccine mandate.

In a published opinion from Circuit Judge John K. Bush, the court held that MSU’s policy “furthers a legitimate government interest of protecting public health.”

Bush added: “Thus, the policy passes rational basis review. Given that MSU’s policy satisfies rational basis review, no employee’s rights are violated, and thus the policy is not an unconstitutional condition on plaintiffs’ employment.”

The panel, including Judges Raymond M. Kethledge and Helene N. White, also rejected the plaintiffs’ argument [Read More]

Health departments, both state and local, learned many lessons from going through the COVID-19 pandemic. Communications, making friends and funding stood out as top of mind.

Michigan Association of Local Public Health Executive Director Norm Hess said the group was having a “high-level review” to look at the pandemic response and would release it in June or July.  He said there was one lesson that all areas of health quickly had to learn.

“The communication aspect is definitely something that we want to delve into and make sure that in the future we have really good processes for that,” Hess said.

He said in the beginning, the federal Centers for Disease Control had to get [Read More]

A nationwide shortage of cancer drugs cisplatin and carboplatin has Michigan hospitals asking state and federal government leaders for help.

Manufacturing delays at several pharmaceutical companies are causing the nationwide shortages of the two critical chemotherapy medications, which are used to treat several types of cancer, including bladder, lung, ovarian and testicular cancers.

As a result, Michigan hospitals and health systems are forced to find alternative treatments for patients, some of which may be less effective, the Michigan Health & Hospital Association said.

“The MHA is in communication with our members of Congress to make them aware of the extent of the drug shortage and any potential solutions,” said John Karasinski, MHA’s senior director [Read More]

By EWA MATUSZEWSKI

I get the sense I have written this column before. If I have, I approach this version with more vim and vigor and, admittedly, a bit of annoyance. The topic is physicians organizations, what they do, who they serve and what they are – and are not.

What they definitely are not, is new. I begin with this, because a respected Michigan business publication recently published an article about a physicians’ organization that formed to counter the efforts of large health systems trying to control their anesthesia specialty. Perhaps it was a beat unfamiliar to the reporter, but the article was written as if physician organizations were a new [Read More]

By STEPHEN SHAVER, Wachler & Associates, P.C.

The US Department of Health and Human Services (HHS) Office of Inspector General (OIG) recently released a report outlining the results of a review it conducted of claims for physician and other practitioner services provided to Medicare patients during Medicare Part A covered skilled nursing facility (SNF) and hospital stays. OIG asserted that physicians were miscoding the location where these services were provided, leading Medicare to make tens of millions of dollars in overpayments. This report is likely to lead to overpayment demands, further audits of providers, and increased scrutiny of place of service (POS) codes.

Each time a physician or other fee-for-service (FFS) healthcare [Read More]

By SARA JODKA

Introduction

As the intersection of technology and healthcare becomes increasingly nuanced, the field of genomic medicine is rapidly evolving and expanding. Genomic medicine, or personalized medicine focusing on the data holding information on base sequence in an individual’s genome, uses an individual’s genetic information to guide healthcare decisions. This revolutionary medical field promises immense benefits to patients, researchers, and healthcare providers. Nevertheless, it brings with it a number of complex privacy concerns that must be adequately addressed in law to ensure that patient data remains confidential and secure.

This article examines the current legal landscape, identifies the unique challenges genomic data privacy poses, and explores the opportunities for developing legal [Read More]

Lansing Lines is presented in cooperation with MIRS, a Lansing-based news and information service.

Conversion Therapy Ban Moves Again, Less than 24 Hours Later

Bills that ban conversion therapy for minors were voted out of the House Health Policy Committee after being voted out of a subcommittee less than 24 hours prior.

Conversion therapy, the practice of attempting to change an individual’s sexual orientation, gender identity or gender expression to align with heterosexual or cisgender norms, is not therapy at all, said Rep. Felicia Brabec (D-Ann Arbor), chair of the Behavioral Health subcommittee.

The bills are an explicit ban on “saying to someone, ‘who you are is not OK, and it’s wrong.’ That’s not [Read More]

By DARIUS TAHIR

What use could health care have for someone who makes things up, can’t keep a secret, doesn’t really know anything, and, when speaking, simply fills in the next word based on what’s come before? Lots, if that individual is the newest form of artificial intelligence, according to some of the biggest companies out there.

Companies pushing the latest AI technology — known as “generative AI” — are piling on: Google and Microsoft want to bring types of so-called large language models to health care. Big firms that are familiar to folks in white coats — but maybe less so to your average Joe and Jane — are equally enthusiastic: Electronic medical records giants [Read More]