12/21/2009 - Spirit of Cooperation
The Texas Supreme Court has called for cooperation between parties in e-discovery: “A fundamental tenet of our discovery rules is cooperation between parties and their counsel, and the expectation that agreements will be made as reasonably necessary for efficient disposition of the case.” Partners Michael Warnecke and Bill Morrison discuss the implications with Texas Lawyer.

06/03/2009 - Medicare’s Recovery Audit Contractor Program: RAC Reviews and Appeals
In order to ensure accurate payments under the Medicare fee-for-service program, the Centers for Medicare & Medicaid Services (“CMS”) has implemented the Recovery Audit Contractor (RAC) program. This Health Care Alert provides the most recent information from CMS regarding the start dates for automated and complex reviews, “good cause” claim reopenings, the five-level Medicare appeals process, limitations on recoupment of alleged overpayments, and charts on the RAC process and Medicare appeals process.

04/23/2009 - False Claims Act: New Rules for Pleading?
In a case that will undoubtedly be embraced by relators, the United States Court of Appeals for the Fifth Circuit recently allowed a lawsuit brought under the False Claims Act (“FCA”) to proceed even though the relator did not know certain details about the invoices he alleged were fraudulently submitted to the government. In United States ex rel. Grubbs v. Kanneganti, the Fifth Circuit reversed a district court’s decision to dismiss an FCA claim for failure to allege fraud in sufficient detail. Although relators will argue that the decision opens the door for many more FCA lawsuits to survive early dismissal, the decision does not signal—as relators hope—that courts are abandoning heightened scrutiny.

10/08/2008 - "RACs Are On Their Way"
CMS has begun rolling out the Medicare RAC Demonstration Project on a permanent, nationwide basis. The RACs are paid solely on the amount of overpayments recovered from providers and will work cooperatively with fraud investigators and the Department of Justice. The permanent RAC program was scheduled to roll out on a national basis to the first group of states on October 1, 2008 (including Florida and Colorado), the second group of states on March 1, 2009 (including Texas and California), and the final group on August 1, 2009 (including Louisiana and New Jersey).

08/06/2008 - Whole Foods - Where Does the Federal Trade Commission Go From Here?
Whole Foods has closed its acquisition of Wild Oats, but it may not have much time to enjoy its purchase. The Federal Trade Commission had sought a preliminary injunction to block the merger to give it time to conduct a trial on the merits, but the district court denied the motion.

09/04/2007 - CMS Final Disclosure Rules on Physician Ownership & Physician Coverage of Hospital

06/25/2007 - Healthcare Legislation Update--Texas Legislature 80th Regular Session

04/27/2007 - Federal and Texas Requirements for Disclosure of Physician Ownership

01/08/2007 - Hot Topics in Health Care for Texas' 80th Legislative Session

01/05/2007 - Texas Regulatory Developments: Hospital Licensing and Pain Management Rules

12/19/2006 - 2007 Other Miscellaneous Policies Client Alert

12/01/2005 - Reminder to Update Your Policies and Procedures for 2006

10/31/2005 - Responding to Allegations of Improper Corporate Conduct
This article discusses two issues critical to any response to allegations of corporate wrongdoing: (1) structuring the internal corporate investigation in a manner that effectively responds to the allegations at issue without subjecting counsel to ethical problems that may appear along the way, and (2) dealing with the government once it launches an investigation into your corporate client, including the client’s obligation to protect relevant documents.

08/02/2005 - AmeriChoice False Claims Act Settlement and Impact on Future Medicare/Medicaid Managed Care Contract

07/07/2004 - Proposed Regulations for Ambulatory Surgical Centers Licensed by the Texas Dept. of State Health Svc