Melissa L. Jampol, Member of the Firm in the Health Care & Life Sciences and Litigation practices, in the firm’s New York office, was quoted in the HCCA’s Report on Medicare Compliance, in “Compensation, Investment Interests Converge in Montana Hospital’s $21.2M FCA Settlement.”
Following is an excerpt (see below to download the full version in PDF format):
[T]he connection between practice losses and physicians’ referral would be hard for prosecutors to establish if hospitals defend false claims allegations at trial, says former federal prosecutor Melissa Jampol with Epstein Becker & Green in New York City. “It’s more complicated than meets the eye,” she says. However, compensation arrangements that would be fine outside health care could run afoul of fraud and abuse laws and require careful vetting for fair market value and commercial reasonableness. …
Jampol says hospitals shouldn’t drop their guard about the Stark Law even though its burdens were scaled back in the 2016 Medicare Physician Fee Schedule regulation … and CMS has put out a request for information on how to reduce them further. “A theme throughout all of the investigations and prosecution is they want to prevent overutilization, and that issue has not been taken off the table,” she says.