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Delaware Health Law Blog

Written by Adam Balick on September 30, 2010

Responding to Subpoenas

Recently there has been a surprising increase in the number of subpoenas served on health care providers. Fraud investigations, overpayment investigations, licensing board investigations, carrier audits, personal injury and workers compensation claims, all generate demands for production of records (and sometimes interviews). And while subpoenas have become commonplace for medical practices, the response to a subpoena cannot be treated lightly.

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Written by Adam Balick on July 13, 2010

Delaware Enacts New Laws Impacting Medical Professionals

In the wake of the investigation and prosecution of Dover pediatrician Earl Bradley on hundreds of counts of sexual assault and child molestation, the Delaware General Assembly passed a series of bills designed to enhance the effectiveness of regulators who license medical professionals and law enforcement officials charged with investigating and prosecuting crimes of abuse in Delaware, which bills were signed by Governor Markell on June 30, 2010.

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Written by Adam Balick on June 10, 2010

Delaware Court Upholds Restrictive Covenant in Physician Employment Agreement

In a recent Memorandum Opinion, Judge Herlihy of the Delaware Superior Court held that a restrictive covenant in a physician employment agreement that required the physician-employee to pay the medical practice employer $200,000 in liquidated damages if, during the 2-year period following termination of the agreement, the physician-employee practiced medicine or treated former patients of the employer within a 20-mile radius of the medical practice’s locations, is enforceable as a matter of law.

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Written by Adam Balick on April 5, 2010

Health Care Reform Requires Immediate and Longer Lead Time Changes Regarding CT, MRI and PET Scans

As we continue to review the recently enacted Patient Protection and Affordable Care Act, what is immediately striking is the broad range of regulatory requirements that will impact health care providers. Some of these requirements will not go into effect for a year or more. However, one requirement that became effective immediately upon the President signing the bill relates to in-office referrals for CT, MRI or PET scans.

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Written by Adam Balick on February 4, 2010

As of February 22, Comply with HIPAA Breach Notification Rules or Face Sanctions

The HITECH (“Health Information Technology for Economic and Clinical Health”) Act enacted last February imposed obligations on health care providers to notify patients if their protected health information was used or disclosed in a manner not permitted by HIPAA’s Privacy Rule.

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Written by Adam Balick on October 2, 2009

The OIG issues its 2010 Work Plan

The Office of Inspector General (“OIG”) has issued its Work Plan for fiscal year
(FY) 2010. (The effective date is October 8, 2009.) The OIG issues a Work Plan each year that describes activities that the agency plans to initiate or continue with respect federal health care programs.

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Written by Adam Balick on September 9, 2009

The Office of Inspector General sets its sights on hospice care in nursing homes

On September 8, 2009, the Office of Inspector General posted an eye-catching report on Medicare hospice care in nursing facilities. The OIG found that 82 percent of hospice claims for beneficiaries in nursing facilities did not meet at least one Medicare coverage requirement. The Medicare hospice benefit allows a beneficiary with a terminal illness to forgo curative treatment for the illness and instead receive palliative care. Medicare paid approximately $1.8 billion for these claims.

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Written by Adam Balick on July 30, 2009

New Amendments to the Delaware False Claims Act May Signal More Claims Against Health Care Providers

After more than two years of trying to pass a law amending Delaware’s False Claims and Reporting Act, the House and the Senate were finally able to pass a bill in the last days of the recent legislative session. Governor Jack Markell signed the bill into law late last week. The amendments to the Act provide the State enhanced financial incentives for pursuing False Claims Act recoveries.

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Written by Adam Balick on July 1, 2009

Turning up the HEAT on health care fraud

The United States Department of Justice and the U.S. Department of Health & Human Services have created an interagency team – the Health Care Fraud Prevention and Enforcement Action Team (“HEAT”) – to increase both fraud detection and fraud prevention.

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