November 30, 2012
By Amy Kaufman*
Baylor to Settle False Claims Act Case
Modern Healthcare (11/27) reports that Baylor University Medical Center and affiliates have agreed to settle a whistle-blower lawsuit alleging that the hospital improperly billed Medicare and Tricare for radiation oncology services between January 2006 and May 2010. The settlement agreement, which is between the United States, Baylor University Medical Center, Baylor Health Care System, HealthTexas Provider Network, and two relators, requires Baylor to pay $907,355 to the United States and $250,000 to the relators to cover their attorneys' fees and expenses. Baylor officials continue to deny any wrongdoing and suggested that the settlement arises from the hospital's interest in avoiding the unpredictable litigation expenses it would likely incur by defending the lawsuit in court. (Note: registration is required to access this article.)
U.S. Supreme Court Permits Liberty University to Argue Claims in Fourth Circuit
Los Angeles Times (11/26) reports that the U.S. Supreme Court has agreed to give lawyers for Liberty University in Virginia the opportunity to argue in lower court two claims that the justices did not consider when they reviewed the constitutionality of the Affordable Care Act this summer. Specifically, the lawyers will be permitted to challenge the constitutionality of provisions requiring large employers to provide health insurance to full-time employees or be subject to a tax and relating to coverage for abortion and family planning in the Fourth Circuit. The justices did not indicate that they would be willing to review these claims at a later time as well.
Congress May Cut Funding to Hospitals to Avert Cuts to Physicians
Modern Healthcare (11/29) reports that Congress may use a $7 billion reduction in Medicare evaluation and management payments for hospitals as a way to help pay for delaying a significant pay cut to physicians. The Congressional Budget Office recently estimated the cost of a one-year patch for the sustainable growth-rate formula to be $25.2 billion. The American Hospital Association has estimated that the "average 2.8% Medicare payment cut that would result from such a cut would grow to 5.8% for teaching hospitals and 4.9% for urban public hospitals." (Note: registration is required to access this article.)
Massachusetts Loosens Restrictions on Providing Meals to Physicians
Law360 (11/26) reports that Massachusetts regulators have "loosened restrictions on gifts that pharmaceutical corporations and medical device firms supply to health care practitioners, saying food and alcohol can be provided in conjunction with educational efforts." The state Public Health Council will allow life sciences companies to provide "modest meals" to doctors, but refused to institute a dollar limit on the value of meals or restrict the provision of free food or drinks in certain settings, including resorts and casinos. The council suggested that other rules prohibit the provision of meals and refreshments under such circumstances; therefore, additional restrictions would be superfluous. The state's willingness to loosen these restrictions represents a step back from stricter legislation that the state passed back in 2008. (Note: registration is required to access the full article.)
Brigham Doctors Implant Newly Approved Devices in Patients
The Boston Globe (11/27) reports that doctors at Brigham and Women's Hospital implanted defibrillators under the skin of three patients at risk of cardiac arrest on Monday. Federal regulators recently approved these devices, which had never been implanted prior to this week. Dr. Laurence Epstein, the chief of the arrhythmia services at Brigham and Women's, indicated that the development of this device is "the most significant advance in the technology in years."
*We would like to thank Amy E. Kaufman, Esquire (Patton Boggs LLP, Washington, DC), for providing this week's update.