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Free Annual Medical Check-up Act on second reading at the House of Representatives
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Plan Ahead for Changes to Physician Group Practice Profit Sharing | Bradley Arant Boult Cummings LLP
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Monday, May 24, 2021
Medical groups that have division-based or service-level approaches to physician compensation should spend their summer evaluating their models in light of Stark Law revisions that go into effect on January 1, 2022. The revisions, seen by CMS as a clarification of original intent, will effectively prohibit distributions of profits from designated health services, or DHS, on a service-by-service basis.
Background
The physician self-referral law or Stark Law prohibits a physician from referring a patient to an entity with which the physician (or an immediate family member) has a financial relationship, for the furnishing of DHS including lab, imaging, and hospital inpatient and outpatient services for which payment otherwise may be made under Medicare or Medicaid, unless an exception applies. Physician group practices commonly rely on the in-office ancillary services exception (IOAS) to protect referrals for DHS among physicians within the practice or
VP Leni Robredo (Mark Balmores/Manila Bulletin)
Last Friday, Roque said that the vice president should clarify first her stand on the Chinese vaccine because she earlier backed the Health Professionals Alliance Against COVID-19’s (HPAC) push to review the vaccines when they first arrived in the country.
The Palace official said this as Senator Joel Villanueva made the suggestion for Robredo and President Duterte to make an infomercial to build public trust in the government’s vaccination program.
In her weekly radio show with broadcaster Ely Saludar, Robredo called Roque’s remark “fake news.”
“Binalikan ko, Ka Ely, iyong lahat ng statement kasi alam ko hindi ako kontra sa bakunang galing China. Hindi ko sinasabi na mas masama yung Sinovac or whatever (I looked back, Ka Ely, on all my statements because I know I was never against the vaccine from China. I am not saying that the Sinovac is bad or whatever),” Robredo stressed.
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The U.S. Department of Justice (the “DOJ”) recently settled whistleblower False Claims Act (“FCA”) allegations against The University of Miami (“UMiami”) for $22 million, which resolves claims from three separate lawsuits related to billing practices at UMiami’s off-campus hospital-based facilities (“Off-Campus Hospital Facilities”) and fraudulent claims for laboratory services.
Allegations were first raised in 2013 through the filing of a whistleblower lawsuit. Two additional whistleblower lawsuits were filed in late 2013 and mid-2014. The DOJ intervened in all three and alleged:
UMiami knowingly engaged in improper billing relating to its Off-Campus Hospital Facilities. Off-Campus Hospital Facilities are required to give notice to Medicare beneficiaries explaining that they would face higher costs when receiving services at Off-Campus Hospital Facilities as opposed to physician offices. Here, UMiami a
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