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PubMed1992

Hanlester Laboratories decision: how is it affected by new sanctions and penalties regulations?

The following excerpts from the briefs recently submitted to Administrative Law Judge (ALJ) Stephen Kessel in the Hanlester Laboratories administrative proceeding, deal with the applicability of a January 29, 1992 final rule on fraud and abuse sanctions and civil money penalties (57 Fed. Reg. 3,298 (January 29, 1992) to the case. Counsel for Hanlester Laboratories, Patric Hooper and W. Bradley Tully of Hooper, Lundy & Bookman, Inc. in Los Angeles, argue that the Office of the Inspector General (OIG-HHS) is trying to change the rules "well after the game has been played," and that this "is obviously being done for the sole purpose of negating the rights" of the Hanlester respondents. The Office of the General Counsel (OGC), in a brief prepared by OGC attorney Larry J. Goldberg, contends that ALJ Kessel "must apply these regulations in rendering his decision," arguing that the "regulations at issue do not even involve a change in policy, but merely a clarification." The Hanlester case (The Inspector General v. Hanlester Network et al., No. C-448 (Department of Health and Human Services, Departmental Appeals Board, Civil Remedies Division) was remanded by the Departmental Appeals Board to ALJ Kessel on September 18, 1991. It is the first case to consider the application of the antikickback statute to a joint venture, and is the first HHS civil exclusion case to be brought as the result of allegations of violations of the antikickback statute (see HealthSpan, November 1991, p. 8).

Fees and Charges↗
PubMed1988

Privacy Act of 1974; revision to existing system of records--HCFA. Notice of revision of Privacy Act system of records.

Notice is hereby given that HCFA is revising one of its systems of records, the Medicare Physician Identification and Eligibility Systems (MPIES), HHS/HCFA/BPO No. 09-70-0525, most recently published at 53 FR 21920; June 10, 1988. The Notice is being revised to reflect a change in the Records Source Categories section of the system. The revision contains no new routine uses.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1988

Medicare program, carrier bonuses for increasing physicians' participation or payments--HCFA. Notice.

This notice describes the methodology we will use to award fiscal year 1988 incentive payments to carriers that successfully increase the number of participating physicians, i.e., physicians who agree to accept Medicare's reasonable charge for all Part B services that they provide to Medicare beneficiaries. It implements provision of the Omnibus Budget Reconciliation Act of 1986, the Omnibus Budget Reconciliation Act of 1987, and the Medicare Catastrophic Coverage Act of 1988 which require us to publish a notice in the Federal Register describing our system for providing payment of a bonus to carriers based on their performance in increasing the number of participating physicians or the proportion of payment for participating physicians' services in their service areas.

Awards and Prizes↗