Mid-Atlantic Health Law TOPICS
Did You Know? - Summer 2016
Lead Testing: Did you know that Maryland has announced a new Lead Testing Targeting Plan for Childhood Lead (2015 Targeting Plan), and on March 3, 2016, the Secretary of Health and Mental Hygiene (DHMH) adopted amendments to regulations regarding Maryland's Lead Poisoning Screening Program? The amendments address the changing profile of lead exposure across Maryland, and take into account the lower levels of lead exposure recommended by the Centers for Disease Control and Prevention. Under the 2015 Targeting Plan, the entire State will be deemed an at-risk area, for an initial three-year period, during which providers should test all Maryland children for lead levels at 12 and 24 months of age. At the end of the three-year period, DHMH will re-evaluate its recommendations, based on data collected during the three-year period.
False Claims Act: Did you know that a federal court determined that a provider operating under a reasonable interpretation of an ambiguous Medicare regulation cannot be held liable under the False Claims Act? U.S. v. Anesthesia Associates of Kansas City involved the Medicare requirement that an anesthesiologist must be present when a patient "emerges" from anesthesia. The court found that the definition of emergence was ambiguous, and Anesthesia Associates of Kansas City's (AAKC) interpretation, that the emergence condition could be satisfied in the recovery room, was reasonable, without the anesthesiologist being present in the operating room at the end of the procedure. Therefore, while the court concluded that AAKC's interpretation was opportunistic, the interpretation was also reasonable, and, therefore, AAKC could not have "knowingly" submitted a false claim to Medicare, meaning there was no False Claims Act liability.
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Coming in Future Issues
Vermont All-Payor System
July 04, 2016