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A path to accountable care runs through the FTC

USA - April 30 2010 In spite of the continued public and political division over the Patient Protection and Affordable Care Act (the “Act”), there are elements of the Act that policymakers, regardless of politics, might actually agree upon.

An outlier or an omen? FTC breaks-up hospital’s 2008 acquisition of outpatient imaging and surgery clinics

USA - November 3 2009 For the first time since 1994, the Federal Trade Commission ("FTC") challenged and forced the divestiture of an exclusively outpatient service line acquisition not involving a full-scale hospital or health care system merger or acquisition.

Court finds hospital entitled to HCQIA immunity despite lack of formal hearing

USA - May 28 2009 On April 10, 2009, the Fourth Circuit ruled that a hospital was immune from various state and federal claims under the Health Care Quality Improvement Act ("HCQIA") for suspending a physician’s privileges without affording him a hearing.

OIG refines Self-Disclosure Protocol through Open Letter to Health Care Providers

USA - May 28 2009 On March 24, 2009, the Office of Inspector General ("OIG") of the Department of Health and Human Services released an "Open Letter to Health Care Providers" providing further refinements to the OIG’s Self-Disclosure Protocol ("SDP").

Medical center files lawsuit challenging RAC’s denial of claim on the basis that the RAC’s opening of the claim was not timely

USA - May 28 2009 On March 24, 2009, a California medical center filed a complaint in the U.S. District Court for the Southern District of California, alleging that the Recovery Audit Contractor (“RAC”) unlawfully reopened a Medicare claim submitted by the medical center.