About Jennifer Sullivan

Jennifer Sullivan practices as part of Caplan and Earnest’s Health Law section. Ms. Sullivan’s practice emphasizes all areas of health law, and she has been listed in Best Lawyers in America® multiple times.

CMS Updates Stark Law to Improve Health Care Delivery

The Center for Medicare and Medicaid Services (CMS) issued a Final Rule [80 Federal Register 70886, 71300] making changes to the Physician Self-Referral Law (i.e. “Stark Law”) on Oct. 30. The Final Rule, which was published in the November 16, 2015 Federal Register, represents the first major updates to the Stark Law since 2009. Most of the provisions in the [...]

By |2016-12-27T11:06:28-06:00January 7, 2016|

Maintaining Compliance When Entering Into Physician Professional Service Agreements

Professional Service Agreements (PSAs) are an increasingly popular mode of collaboration between physicians and hospitals, and for good reason. PSA establish the terms on which a physician or physician group will provide services to a hospital or health care facility on an independent contractor basis.  Thus, these arrangements offer an alternative to direct employment of physicians by a hospital.  From [...]

By |2016-12-27T11:06:28-06:00January 5, 2016|

CMS Publishes Proposed Rule with Modifications to Stark Law

The Centers for Medicare and Medicaid Services recently published the 2016 Physician Fee Schedule, which notably included several proposed modifications to the Stark Law, or Physician Self-Referral Statute. The Stark Law prohibits physicians from making referrals for designated health services (DHS) payable by Medicare to entities in which the physician has a financial interest, unless the financial relationship meets an [...]

By |2016-12-27T11:06:36-06:00July 29, 2015|

Tuomey Healthcare Systems Hit with $237 Million Judgment for Stark Law Violations

Earlier this month, nonprofit hospital Tuomey Healthcare Systems, which serves an underserved rural South Carolina community, was handed a “likely death sentence” judgment of $237 million owed for Stark Law violations. The Fourth Circuit Court of Appeals affirmed the decision, which may have unsettling ramifications for physician compensation for all hospitals. In the original case appealed in United States Drakeford [...]

By |2016-12-27T11:06:37-06:00July 14, 2015|

Practical Guidance for Health Care Governing Boards on Compliance Oversight

The Office of the Inspector General of the Department of Health and Human Services recently published “Practical Guidance for Health Care Governing Boards on Compliance Oversight” in collaboration with a number of leading health care organizations. Previous guidance from the OIG has emphasized the need for governing boards to be fully engaged in the oversight of their organization’s compliance program.  [...]

By |2015-06-04T08:43:19-06:00June 3, 2015|

False Claim Act Liability for Worthless or Substandard Care in Long Term Care

Late last year, the United States Department of Justice announced that Extendicare Health Services, Inc., which operates skilled nursing facilities, agreed to pay $38 million to the federal government and eight states to settle False Claim Act (FCA) allegations brought by two whistleblowers.  One of the whistleblowers in the Extendicare case was a former employee whose claims included upcoding of [...]

By |2016-12-27T11:06:40-06:00March 23, 2015|

CMS Delays Final Rule on Reporting and Returning Overpayments

The Centers for Medicare and Medicaid Services recently announced a one-year delay in the publication of the final rule regarding reporting and returning overpayments to the Medicare program. A proposed rule, which was originally published on Feb. 16, 2012, requires providers and suppliers to report and return Medicare overpayments within 60 days after the date on which the overpayment was [...]

By |2016-12-27T11:06:42-06:00March 5, 2015|

Critical Access Hospitals May Face Budget Cuts

The recent release of the Obama Administration’s 2016 budget proposal suggests that budget cuts could be coming to critical access hospitals. In a notable change, the budget proposal does not allow hospitals that are within 10 miles of another hospital to have the critical access designation, which could have repercussions for a significant number of hospitals presently designated as critical [...]

By |2017-01-24T15:36:44-06:00February 24, 2015|

CMS Releases New Provider Enrollment Regulations

The Centers for Medicare & Medicaid Services (CMS) published this month its final rule addressing provider enrollment regulations. These new regulations will be effective February 3, 2015, create new tools to monitor provider enrollment, and signal that CMS intends to use the Medicare enrollment process as an enforcement tool. Highlights of the provider enrollment provisions include: CMS can deny enrollment [...]

By |2015-02-17T13:06:11-06:00December 22, 2014|

DOJ Reports Record Year for False Claims Recoveries

The U.S. Department of Justice continues to focus on fraud and false claims against the government, announcing it obtained a record $5.69 billion in settlements and judgments from civil cases in the fiscal year ending Sept. 30, 2014. Acting Associate Attorney General Stuart F. Delery and Acting Assistant Attorney General Joyce R. Branda for the Civil Division recently announced the [...]

By |2016-12-27T11:06:53-06:00December 16, 2014|