On July 31, 2019, the U.S. Court of Appeals for the Eleventh Circuit affirmed a lower court’s decision, in favor of HCA (a publicly-traded healthcare services provider), to grant summary judgment on certain claims, and dismiss other claims, brought by Thomas Bingham, a real estate appraiser and “ serial relator .” Bingham alleged that HCA provided “ sweetheart deals ” to physician tenants in connection with medical office building (MOB) projects in Missouri and Florida, through the provision of subsidies to developers, which developers in turn passed on to the physician tenants in the form of office improvements, low initial lease rates, cash-flow participation agreements, marketing, and restricted use waivers.  (Read more...)  

On September 6, 2019, the U.S. Department of Justice (DOJ) announced that the owner and chief executive officer (CEO) of a telemedicine company pleaded guilty for his role in one of the largest healthcare fraud schemes ever investigated by the Federal Bureau of Investigation (FBI) and the U.S. Department of Health and Human Services Office of the Inspector General (HHS-OIG), and prosecuted by the DOJ, stemming from April 2019 charges against 24 defendants. Lester Stockett, owner of Video Doctor USA, and owner and CEO of Telemed Health Group LLC, pleaded guilty to one count of conspiracy to defraud the U.S. and pay and receive healthcare kickbacks, and one count of conspiracy to commit money laundering.  (Read more...)  

On September 17, 2019, U.S. District Court Judge Rosemary Collyer ruled in favor of the American Hospital Association (AHA) and other related healthcare organizations, and found that the Centers for Medicare & Medicaid Services (CMS) exceeded its statutory authority when it reduced payments for hospital outpatient services provided in off-campus provider-based departments grandfathered under the Bipartisan Budget Act of 2015 (i.e., the site-neutral payments system). Under the site-neutral payment system, which began in 2019, CMS capped the payments to hospitals for outpatient clinic visits at the same rate as physician office clinic visits. (Read more...)  

An ambulatory surgical center (ASC) is a distinct entity that primarily provides outpatient surgical procedures to patients who do not require an overnight stay after the procedure. The facilities typically provide relatively uncomplicated surgical procedures in a non-hospital setting, and most ASC cases are non-emergency, non-infected, and elective. ASCs typically specialize in one or two procedures/specialties (particularly related to ophthalmology, gastroenterology, or orthopedics). If there is general anesthesia administered, the procedure does not usually exceed one hour in length, and requires less than a two-hour stay in the recovery room. (Read more...)  
On October 17, 2019, HCC President,  Todd Zigrang , and Vice President and General Counsel,  Jessica Bailey-Wheaton , will be presenting at the Missouri Society of CPAs ' Healthcare Industry Conference, on the topic of The Due Diligence Imperative in the Era of Value-Based Reimbursement.

Advanced Distance Education to Launch in 2019

The  Institute for Healthcare Valuation  (IHV) &  Consultants' Training Institute  (CTI) are pleased to announce premier healthcare valuation training through a distance education program, the Certificate of Educational Achievement (CEA) for Advanced Education in Healthcare Valuation. The program will launch in 2019 and will bridge the interdisciplinary nature of healthcare valuation to include: the Four Pillars of Healthcare (regulatory, reimbursement, competition, and technology); the market forces shaping the U.S. healthcare industry; and the valuation of healthcare enterprises, assets, and services. Legal professionals and healthcare providers, as well as those wishing to expand their scope of activities in healthcare valuation engagements and those seeking to enhance their current healthcare valuation service lines, will gain comprehensive knowledge through completing the expansive program. The program has been developed and is being presented by industry thought leader Health Capital Consultants , alongside a blockbuster faculty of healthcare subject matter experts from the legal, federal regulatory, and valuation professions.

HCC President, Todd Zigrang , and Vice President and General Counsel, Jessica Bailey-Wheaton , were recently interviewed by the National Association of Certified Valuators and Analysts (NACVA) , where they discussed the development of the distance education program along with the topics that will be covered. Click HERE to watch the entire interview.