Telemedicine Alert

March 24, 2017

The State Medical Board of Ohio (SMBO) has released Rules 4731-11-01 and 4731-11-09 which take effect March 23, 2017.  As previously reported in Ohio Medical Board Telemedicine Prescribing Rule Update, the SMBO has chosen to take an approach consistent with several other states’ more recent statutory/regulatory amendments to their telemedicine rules.  That is, rather than delineating a set of specific  requirements as to how a physical exam should be conducted remotely, the SMBO has taken a more balanced approach focusing instead on documentation of the visit, informed consent, follow-up care, etc.  With regard to the issue of how to properly conduct a remote physical exam, the rule leaves the discretion of whether or not telemedicine is the appropriate forum for the patient visit where it belongs, with the provider. As an initial matter, Rule 4731-11-09 defines “informed consent” as: [a] process of communication between a patient and physician discussing the risks and benefits of, and alternatives to, treatment through a remote evaluation that results in the patient’s agreement or signed authorization to be treated through an evaluation conducted through appropriate technology when the physician is in a location remote from the patient. Further, a “patient” is defined as: [a] person for whom the physician provides healthcare services or the person’s representative. Additional definitions and references of importance are contained within Rule 4731-11-01. With regard to the central purpose of 4731-11-09, Prescribing to persons not seen by the physician, the rule now authorizes a provider to prescribe non-controlled substances to a patient whom the provider has never physically examined and who is in a remote location from the provider, when the provider: Establishes the patient’s identity and physical location; Obtains the patient’s informed consent for treatment through remote examination; Obtains the patient’s consent to forward the medical record to the patient’s PCP or other healthcare provider; Completes a medical evaluation through interaction with the patient that meets the minimal standards of care appropriate to the condition for which the patient presents; Establishes a diagnosis and treatment plan, including documentation of necessity for the utilization of a prescription (non-narcotic) drug; including contraindications to the recommended treatment; Documents the consent to remote care, pertinent history, contraindications and referrals made to other providers; Provides appropriate follow-up care or recommended follow-up care; Makes the medical record of the visit available to the patient; and Uses appropriate technology that is sufficient for the physician to conduct all of the above steps and as if the medical evaluation occurred in-person. Read More

PBI’s 23rd Annual Health Law Institute

March 8, 2017

Marc Stephen Raspanti and Pamela Coyle Brecht will discuss, “Dealing with States in Complex Health Care Fraud Investigations,” at PBI’s 23rd Annual Health Law Institute. The event takes place at the Pennsylvania Convention Center in Philadelphia, PA. Read More

PBI’s 23rd Annual Health Law Institute

March 7, 2017

Martin T. Durkin will discuss, “Telemedicine and the Legal Challenges that Keep us from Building a Virtual Mayo Clinic,” at PBI’s 23rd Annual Health Law Institute.  The event takes place at the Pennsylvania Convention Center in Philadelphia, PA. Read More

HCCA San Francisco Regional Conference

December 2, 2016

Pamela Coyle Brecht will speak on “Medicare Part C & D Compliance” at the Health Care Compliance Association’s San Francisco Regional Conference at the Walnut Creek Marriott in Walnut Creek, CA. Read More

Telemedicine- Just A Fancy Word For Plain Old Medicine?

October 24, 2016

Although “telemedicine” is not some new type of medical breakthrough but rather a vehicle for the delivery of “medicine”, its wide-spread use in delivering medical care in many different scenarios can get bogged down by serious regulatory issues such as: the lack of medical license reciprocity among the states (notwithstanding an increasing number of states adopting the Federation of State Medical Boards Interstate Medical Licensure Compact); the type of informed consent that needs to be given before care is rendered via telemedicine; differing opinions from state-to-state about the standards of care specific to medical care delivered via “telemedicine”; inefficient availability of patient’s medical records and the privacy of those records from state-to-state; requirements for certificates of need in some states to practice even basic forms of medicine; even the types of entities that can legally employ doctors varies among the states.  A high profile example of the challenge of standard of care issue’s confronting medical boards is well documented in the high-profile Texas http://bit.ly/2dyfz2F cases involving Teladoc. But numerous other states are having their own challenges that are not much different from Texas.  For example, Ohio http://bit.ly/2dygIaq and Arkansas http://bit.ly/2dydT9x have had their own challenges. Even in the absence of these regulatory issues in some states, you still have the fact that health insurers’ payment for telemedicine services currently amounts to less than 1 percent of all of the reimbursements paid to health care providers and health care facilities, although there is some movement on these fronts too. http://bit.ly/2dyfYCg While the promise of telemedicine technology as a form of connecting providers with their patients continues to innovate exponentially, adoption is way behind innovation.  The hot topic for the past several years that garners the most news coverage is “convenience care”, but that is just one aspect of the true value that telemedicine can bring to the table in the delivery of medical care.  Read More

A New Era of Laboratory Fraud Explained in Compliance Today

September 2, 2016

PHILADELPHIA, PA – Marc Stephen Raspanti, Pamela Coyle Brecht and Douglas E. Roberts, attorneys at the law firm Pietragallo Gordon Alfano Bosick & Raspanti, LLP, authored an article titled, “A New Era of Laboratory Fraud, Part 1: Operation LabScam Redux,” that was published in the September 2016 edition of Health Care Compliance Association’s Compliance Today. Part 2 of this article will be featured in the October issue. An early 1990s government investigation called, “Operation LabScam” returned more than $800 million to the government from clinical laboratories that had billed Medicare and other government healthcare programs for medically unnecessary tests, upcoded tests, and tests that were never conducted and provided kickbacks to physicians who referred patients for the illegal testing.  This investigation was supposed to reform the laboratory industry, but now new cases of lab-based fraud and abuse have emerged. Presently, Biodiagnostics Laboratory Services, Inc. was caught participating in a massive scam orchestrated over a seven-year period that involved bribing doctors in three states to refer patients to the lab for medically unnecessary tests. The scam resulted in a mass prosecution of laboratory executives, associates and physicians. The fines handed out to labs are some of the largest settlements ever recovered under the False Claims Act. Pietragallo is one of the nations most experienced and respected law firms handling complex qui tam actions brought under the both the federal and the state false claims acts. Mr. Raspanti, a name partner at the firm, is recognized as one of the most successful, skilled and experienced qui tam attorneys in the United States. He has served as lead counsel for whistleblowers in false claims cases that have resulted in over $2 billion in recoveries for federal and state taxpayers. Ms, Brecht, a partner, is a vibrant member of the Qui Tam Practice Group and litigates some of the most complex Qui Tam cases filed in the United States.  Read More

Seton Hall Law School’s Healthcare Compliance Certification Program

June 14, 2016

Marc S. Raspanti will speak at Seton Hall Law School’s Healthcare Compliance Certification Program on the False Claims Act litigation. Read More

PICPA Health Care Conference

June 14, 2016

Michael A. Morse will give an update on “Health Care Fraud and Abuse” at the PICPA (Pennsylvania Institute of Certified Public Accountants) Health Care Conference on June 14, 2016.  The event takes place at the Wyndham Gettysburg in Gettysburg, PA. Read More

Pamela Coyle Brecht to Speak at South Carolina Bar Health Care Law Seminar

April 26, 2016

PHILADELPHIA, PA – Pamela Coyle Brecht, partner at the law firm Pietragallo Gordon Alfano Bosick & Raspanti, LLP, will speak at the “False Claims Act/Qui Tam Whistleblower Litigation Involving Health Care Providers” seminar at the South Carolina Bar Conference Center in Columbia, SC on Friday, May 6, 2016. She will be accompanied by esteemed local and national panelists. Ms. Brecht will present on “Private Causes of Action Accompanying FCA Qui Tam Cases”and will also be part of a panel discussion on “Hot Topics from the Plaintiff’s Perspective.” The seminar will focus on federal False Claims Act litigation and the health care industry.  It’s designed to inform attendees on emerging issues arising out of False Claims Act lawsuits involving the clinical health care industry including hospitals, hospices, pharmaceuticals, ambulance companies and laboratories. The program is hosted by the South Carolina Bar Health Care Law Section, South Carolina Bar CLE Division and the South Carolina Federal Bar Association Qui Tam Section. Ms. Brecht is a vibrant member of the Qui Tam Practice Group at Pietragallo. She is also experienced in employment law, internal investigations, white collar criminal litigation, and complex health care litigation. She litigates some of the most complex Qui Tam cases filed in the United States. Her cases have included alleged fraud by a large multi-state Medicaid managed care contractor, FCA violations by three of the largest hospital corporations in the country, and complex financial relationships among healthcare providers, clinical laboratories as well as myriad pharmaceutical fraud. Ms. Brecht is a 1988, cum laude, graduate of Villanova University and a 1991 graduate of Temple University School of Law. While attending Temple University School of Law, Ms. Brecht served as a member of the Temple Law Review and received honors for Distinguished Class Performance. Ms. Brecht is a member of the Philadelphia Bar Association, the American Health Lawyers Association, the Health Care Compliance Association, and the Federal Bar Association Qui Tam Section. Read More

Marc Stephen Raspanti to Speak at the South Carolina Bar Health Care Law Seminar

April 26, 2016

PHILADELPHIA, PA – Marc Stephen Raspanti, partner at the law firm Pietragallo Gordon Alfano Bosick & Raspanti, LLP, will speak at the “False Claims Act/Qui Tam Whistleblower Litigation Involving Health Care Providers” seminar at the South Carolina Bar Conference Center in Columbia, SC on Friday, May 6, 2016. Mr. Raspanti will present on “False Claims Act Pleadings & Related Issues” and will also be a part of a panel discussion on “Hot Topics from the Plaintiff’s Perspective.”  The seminar will focus on federal False Claims Act litigation and the health care industry. It’s designed to inform attendees on emerging issues arising in the context of False Claims Act lawsuits involving health care industries including hospitals, hospices, pharmaceuticals, ambulance companies and laboratories. The program is hosted by the South Carolina Bar Health Care Law Section, South Carolina Bar CLE Division and the South Carolina Federal Bar Association Qui Tam Section. Mr. Raspanti, who is a former prosecutor, is recognized as one of the most successful, skilled and experienced qui tam attorneys in the United States. Since 1989, Mr. Raspanti has litigated many of the most complex and important cases in the history of the federal False Claims Act. He has served as lead counsel for whistleblowers in false claims cases that have resulted in over $2 billion in recoveries for federal and state taxpayers. He practices in the areas of federal and state qui tam litigation, federal and state white collar litigation; criminal and civil health care fraud defense; and complex commercial litigation. Mr. Raspanti received his B.A. from Villanova University in 1979 and his J.D. from Temple University School of Law in 1984.  Mr. Raspanti was selected by his peers as one of Pennsylvania’s Super Lawyers from 2004 through 2015 in the field of White Collar Criminal Defense, an honor reserved for 5% of the Pennsylvania Bar. Read More