Eric Fader was quoted in an article, “Telemedicine Facing Increased Government Scrutiny,” published in Bloomberg Law’s Health Law & Life Sciences News. The article discusses the increasing scrutiny of telemedicine services by government agencies as questions regarding fraud, waste, and abuse increase. A recent report by the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) uncovered numerous improper telemedicine claims, including some in which Medicare patients received services at ineligible locations and others that were billed by ineligible providers. Fader told Bloomberg Law that fast-growing healthcare sectors like telemedicine are often particularly vulnerable to abuse, as well as honest mistakes as provider education and oversight lag behind increasing utilization. “Telehealth is a classic example because the rules have been in flux, education and training of practitioners has been lacking, and [the Centers for Medicare & Medicaid Services (CMS)] apparently hasn’t yet put telehealth claims on its radar screen for oversight,” Fader said.
One problem for telemedicine, he observed, is that the different arms of the HHS aren’t coordinating with one another. Although the HHS’s Health Resources and Services Administration’s Medicare Telehealth Payment Eligibility Analyzer allows providers to check whether an originating site is eligible for Medicare reimbursement, in most of the claims that the OIG deemed improper, the patient was not treated at such a site. However, since provider claim forms don’t require that information, the CMS must take the provider’s word that treatment was provided at an eligible site. “I’m sure some practitioners are simply confused, while others are taking advantage of the lack of oversight and submitting claims they know shouldn’t be reimbursed,” Fader said. The volume of telemedicine claims will only be increasing, he added, and if the CMS doesn’t get a handle on the problem the dollars lost to fraud will increase as well.
On May 31, Michael Furey will be speaking at "Commercial Litigation from the Masters," a program being presented by the New Jersey Institute for Continuing Legal Education (NJICLE) and being held at the New Jersey Law Center in New Brunswick, NJ.
Erin Magennis Healy, Lori J. Braender and Thomas A. Zalewski authored an article, "A Provider's Guide to Managing a Medical Device Recall," which was published in the American Health Lawyers Association Journal of Health & Life Sciences Law.
Susan Huntington and Danielle Corcione will present an educational call-in discussion, "The Focus on Individuals in Fraud Investigations and Considerations for D&O Insurance," for the American Health Lawyers Association on November 9 from 11 a.m. to 11:45 a.m.
Eric Fader authored a chapter in the 2017 edition of Westlaw's "Data Security and Privacy Law" treatise, published by Thomson Reuters.
On March 15, Eric Fader will be presenting a live webinar, "Navigating Legal Issues in Neuromonitoring," for The American Society of Neurophysiological Monitoring (ASNM).
On August 2, Eric Fader was quoted in an article, "California's Dreaming of Tougher Health-Care Privacy," published in Bloomberg Law's Health Law & Life Sciences News.
On July 24, Eric Fader was quoted in an article, "Help Wanted: Medicare Looking for Health Tech Expert," published in Bloomberg Law's Health Law & Life Sciences News.
Michael Furey was quoted in an article, "An inside look at how Horizon used hospital costs – and quality – in plan to change N.J. health care," which was published on NJ.com and also appeared in the July 29 edition of The Star-Ledger under the headline, "Reports: Horizon Skewed Quality, Costs on New Plan."
Day Pitney partners Michael Furey and David Waizer were recognized in the inaugural NJBIZ Vanguard Series: Leaders in the Law.
Michael Furey was quoted in an article, "Confidential Documents Suggest Horizon Misled Public on how it Picked Hospitals for OMNIA Program," which was published in The Star-Ledger and on NJ.com.