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Seven Things To Know When You Receive A Notice Of Investigation From The Department Of Health

Stat Law Update August 2009

Health Reform

On July 14, 2009, a health care reform bill was introduced in Congress and quickly endorsed by President Obama.  The AMA has also voiced its support for the reform bill.  Opponents claim the bill as written would mean the death of private health insurance. 

GlaxoSmithKline Allowing Copies of HIV Meds

In a July 14, 2009, press release, GlaxoSmithKline announced that it will permit other companies to copy some of its patented HIV medicines for distribution in Africa and other poor countries.  The company also announced the creation of the Positive Action for Children Fund, which will focus on preventing HIV in children. 

CMS Scrutinizing Ultrasound Claims

A recent study by the Department of Health and Human Services Office of Inspector General (OIG) determined that approximately one in five claims for ultrasound services raised concerns about the legitimacy of the claim.  According to the OIG, the questionable claims amount to 19% of the $2.1m Medicare Part B pays for ultrasounds each year.  The study identified 20 counties in the United States with an unusually high number of questionable claims for ultrasound services.  Nine of those counties are in Florida according to the report.

Evidently Repaying Medicare Is As Difficult As Getting Paid By Medicare

Some personal injury attorneys are reporting difficulty repaying Medicare for the health care provided to their clients from settlement proceeds.  One lawyer reported it took Medicare two years to respond to his inquiry on how much was owed to Medicare.  Another lawyer stated it was nearly impossible to speak with a live person at Medicare and his written correspondence went unanswered.

You Have A Right To Remain Silent So Use It

I read this on a criminal defense attorney’s newsletter, but I changed some of the wording to protect the easily offended.  You have the right to remain silent, so SHUT UP.  The cops, investigators, auditors, agents and officials WILL use what you say against you.  They are not your friends and they are just pretending to like you.  Investigations of any kind are serious matters that put a physician’s reputation and license at stake.  Physicians are trained to be self-reliant so they attempt to handle these matters themselves, but they generally lack the objectivity and distance necessary to resolve these situations successfully.  Therefore, you have the right to remain silent so use it and consult competent legal counsel.