The Healthcare Fraud & Compliance Interest Group addresses topical, cutting edge issues which are the focus of fraud and abuse prevention, investigations and prosecutions, including but not limited to compliance issues, emerging managed care issues, kickback and Stark Law issues, institutional and non-institutional and physician issues, ethical issues, false claims issues, quality of care issues, and private sector as well as private sector enforcement initiatives.

New Stark Proposals in 2008 Physician Fee Schedule

On July 2, the Centers for Medicare and Medicaid Services ("CMS") released its proposed revisions to the Medicare Physician Fee Schedule for 2008. Included in the proposing release were a number of proposed revisions to the regulations under the Stark self-referral law, as well as the solicitation of comments on other potential revisions to the Stark regulations. While these proposals are, obviously, just proposals, they provide important guidance as to potential changes in the Stark regulations and provide healthcare entities and physicians with an important opportunity to comment on these prospective changes before they become law. Set forth below a brief summary of the proposed Stark Law changes and requests for comment below. Of course, this is just a summary, and does not reflect all information in the CMS proposal, which is available (all 924 pages of it) CMS and will be published in final form in the Federal Register later this month. [Read More]

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Current Interest Group Roster (1,010 members)
(Accessible to ABA Members)

Chairs

Chair
Carol A. Poindexter
Shook, Hardy & Bacon LLP
2555 Grand Blvd.
Kansas City, MO 64108
T: 816/474-6550 F: 816/421-5547
cpoindexter@shb.com

Vice Chairs
Gilbert F. Ganucheau, Jr.
Kathleen L. DeBruhl & Associates LLC
614 Tchoupitoulas St.
New Orleans, LA 70130-3212
T: 504/522-4054 F: 504/522-9049
gganucheau@md-law.com

Glenn M Jones
Fulbright & Jaworski L.L.P.
801 Pennsylvania Ave. N.W.
Washington D.C. 20004
T: 202/662-4605
gmjones@fulbright.com

Davis W. Turner
Vanguard Health Systems, Inc.
Vice President & Assistant General Counsel
20 Burton Hills Boulevard, Suite 100
Nashville, TN 37215
T: 615/665-6317 F: 615/665-6197
dturner@vanguardhealth.com

Liaisons

Government Submissions & Policy
Susan L. Burke
Montgomery McCracken Walker & Rhoads, LLP
123 South Broad Street
Avenue of the Arts
Philadelphia, PA 19109
T: 215/772-7514 f: 215/772-7620
slburke@mmwr.com

Membership
Jennifer R. Luong
Counselor on Oversight
U.S. Department of Health and Human Services
Office of the Assistant Secretary for Legislation
T: 202/690-7298
Jennifer.Luong@hhs.gov
(202) 690-7298

Technology
Davis W. Turner
Vanguard Health Systems, Inc.
Vice President & Assistant General Counsel
20 Burton Hills Boulevard, Suite 100
Nashville, TN 37215
T: 615/665-6317 F: 615/665-6197
dturner@vanguardhealth.com

Focused Program

• OIG Releases Advisory Opinion 08-07 Concerning $10 Gift Cards for "Service Shortfalls"
• OIG Releases FY 2007 Medicaid Fraud Control Units Annual Report
• OIG Testifies at House Subcommittee on Oversight & Investigations on Nursing Home Quality Issues
• OIG Releases Health care Fraud and Abuse Control Program Annual Report for FY 2006
• CMS Posts Stark FAQs
• OIG Advisory Opinion (07-17) Concerning A Proposal By The Requestor
• OIG Solicits Proposals & Recommendations for New Safe Harbors/Fraud Alerts
• New Stark Proposals in 2008 Physician Fee Schedule
• Safe Harbors
• CMS Says Specialty Hospitals Participating In Medicare Must Meeting Emergency Care Conditions of Participation
• CMS Briefing on DRA Section 6032 Compliance Answers Some Questions, Raises Others
• OIG State Falsce Claims Act Reviews
• U.S. Deputy Attorney General Paul J. Mcnulty Revises Charging Guidelines for Prosecuting Corporate Fraud
• HS: Response to Request for Guidance Regarding Certain Physician Investments in the Medical Device Industries
• August 21, 2006: False Claims Act Settlements
• FAA Imposes $1 Million Civil Penalty Against Air Ambulance Provider
• U.S. Sentencing Commission Votes To Amend Guidelines For Terrorism, Firearms, And Steroids
• Notice Of Submission To Congress Of Amendments To The Sentencing Guidelines Effective November 1, 2006
• OIG Semi-Annual Report To Congress
  • Corresponding Press Release
• Waived Stark Self-Referral Requirements in Declared Katrina Disaster
• CMS Issues Interim Final Rule Addressing Physician Self-Referrals

• 2007 - 2008 Healthcare Fraud & Compliance Interest Group Action Plan
• Office Of Inspector General Work Plan 2006
• HIPAA Questions & Answers
• Physician Self Referral - Section 1877 of the Social Security Act
• Physician Self Referral - Advisory Opinions
• HHS OIG Advisory Opinions