False Claims Act Case Beaten by Bona Fide Employee Arrangement

false claims actBy: Jeff Cohen     

One healthcare employer’s compensation arrangement with its employees just got much needed support from the 11th Circuit Court of Appeals.  The employer there, which provided AIDS patients certain healthcare related services, paid its employees a bonus of $100 per patient.  The case was brought on the argument that the compensation arrangement constituted an illegal kickback under the federal Anti- Kickback Statute.  The court, however, disagreed because the employees who received the bonuses were “bona fide employees.”

The court’s focus on the plain language of the safe harbor for bona fide employees was refreshingly clear, notably that “any amount paid by an employer to an employee (who has a bona fide employment relationship with such an employer) for employment in the furnishing or any item or service.”  Essentially, any amount paid by an employer to a bona fide employee is not considered to be “remuneration” under the Anti-Kickback Statute.Continue reading

State Court Ruling on Patient Brokering Act Threatens Healthcare Facilities and Providers

patient brokering actA recent ruling by a state trial court handling the Palm Beach County Sober Home Task Force prosecutions against providers of addiction treatment and sober home services is creating lots of confusion and alarm around the state and could have very far reaching consequences for the entire healthcare industry well beyond addiction treatment.

The issue presented by the prosecution focuses on whether a person charged with violating the state’s Patient Brokering Act (PBA) can be found guilty even if he/she didn’t know what he was doing was unlawful. The PBA broadly prohibits paying someone for patient referrals, very much like the federal Anti-Kickback statute.  If allowed, the client would have gotten legal advice, paid for it, followed it, and still not be able to show a judge or jury that, despite all their best efforts, they simply followed the law as instructed.

Can a healthcare facility or provider be guilty of violating a criminal law [the PBA] if they’d gotten legal advice and followed it?  Traditionally, the answer would be a clear “no.”  The argument against the State’s position would be something like “How can someone intend to violate a criminal law if they got legal advice regarding how to comply with it and then followed that advice?”  The argument of the state might look something like “We don’t even think the judge or jury ought to be able to hear that the person got legal advice and followed it.”  The court punted the issue to the appellate court.Continue reading

Is Your Substance Abuse Marketing Service Licensed? Check Here

healthcare fraud

addiction marketingBefore doing business in Florida, an entity providing substance abuse marketing services must be licensed by Florida’s Department of Agriculture and Consumer Protection. This includes includes either telephone solicitation from a location in Florida or solicitation from other states or nations for substance abuse and addiction treatment centers located in Florida.

As of November 27, 2017, only the following entities are licensed by the State of Florida to provide marketing services to substance abuse and addiction treatment centers:

  • A Way and a Means, LLC (Delray Beach, Florida)
  • Addiction International Holdings, LLC d/b/a The Addiction Advisor d/b/a The Recovery Miracle (Boca Raton, Florida)
  • Advanced Recovery Systems, LLC (Winter Park, Florida)
  • Bandwidth Interactive Company d/b/a Local Management (Boca Raton, Florida)
  • Delphi Behavioral Health Group, LLC (Fort Lauderdale, Florida)
  • Freedom From Addiction, LLC (Miami Beach, Florida)
  • Infoworx Direct, LLC d/b/a Addiction Hope and Help Line (Boca Raton, Florida)
  • Invigorate Solutions, LLC d/b/a Local Management (Boca Raton, Florida)
  • Meridian Treatment Solutions, LLC (Lauderdale by the Sea, Florida)
  • NPA Consulting Group, LLC (Pompano Beach, Florida)
  • Palm Partners, LLC (Palm Springs, Florida)
  • Parent Team, LLC (Santa Rosa, California)
  • Pryme Time Media, LLC (Sunrise, Florida)
  • R360, LLC (Fort Lauderdale, Florida)
  • Redwood Recovery Solutions, LLC d/b/a com (Riviera Beach, Florida)
  • Ring2Media, LLC (Westport, Connecticut)
  • Rybchinskiy Inc. (Boynton Beach, Florida)
  • Sober Network, Inc. (Delray Beach, Florida)
  • The Addiction Network, LLC (North Miami, Florida)
  • True Choice Health Group Limited Liability Company (Pompano Beach, Florida)
  • United Addiction Specialists, LLC (Hollywood, Florida)
  • USR Holdings, LLC (Coconut Creek, Florida)

It is a third degree felony for: any person to work for an entity that does not have a current and valid license; or for any entity to invite telephone calls or other communications with a substance abuse marketer who is soliciting clients without a current and valid substance abuse marketing license; or for any person or entity to solicit without a license; or for any person who otherwise violates the law requiring licensure either directly or indirectly. Any person who is convicted of a second or subsequent violation commits a felony of the second degree.

The Truth About Healthcare Regulatory Compliance

false claims act

medical practice complianceBy: Jeff Cohen

Healthcare regulatory compliance is too damn complicated sounding and scary!  What the heck does it even mean?  Basically it means making sure you’re following about a dozen specific laws, some of which interrelate.  It’s a little like making a cake.  You have to make sure you have flour, eggs, sugar and so on.  And then you have to make sure you put enough in the bowl and bake it at the right temperature.  So what’s so unique re healthcare regulatory compliance?  Healthcare professionals and businesses are inundated by these confusing laws written in legalese, to the point where they go numb.  They lose the ability to focus on them and to take them seriously.  And they hire someone that uses the word “consultant” or “compliance”; and they think they’ve got compliance covered.  But they don’t.  And that’s a big mistake in the healthcare world!Continue reading