Healthcare Law Briefs

Meeting the Challenge of Health Law

	What's Inside
	NLRB Ruling Allows Residents, Fellows of Illinois Hospital to Collectively Bargain
	Fraud and Abuse: University of Washington Professor Sentenced for Health Care Billing Fraud
	CMS Announces Web-Based Manual
	Court Decision Provides Some Relief on False Claim Cases
	OIG Posts 2004 Work Plan

Healthcare Law Briefs

*READ PAST ISSUES OF THE HEALTHCARE LAW BRIEFS

1. NLRB Ruling Allows Residents, Fellows of Illinois Hospital to Collectively Bargain

The National Labor Relations Board has given the go-ahead to medical residents and fellows at Advocate Lutheran General Hospital in the Chicago area to organize as a collective bargaining unit, ending a three-year dispute between the hospital and a group seeking to represent the physicians in training ("Advocate Health and Hospital Corp. and Physicians for Responsible Negotiation", N.L.R.B., No. 13-RC-20426, 9/9/03). The NLRB ruling in favor of Physicians for Responsible Negotiation (PRN), a bargaining group supported by the American Medical Association, essentially allows nearly 180 physicians in training at Advocate Lutheran General to organize and collectively bargain on issues such as pay, benefits, and working conditions. Specifically, the NLRB denied Advocate's request for review of the NLRB acting regional director's Nov. 7, 2000, finding that chief residents are not statutory supervisors and, therefore, able to organize. The NLRB also rejected Advocate's contention that residents in a rotating residence program should be included in the petitioned-for unit.

Sept 22 -- BNA's Health Care Daily Report

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2. Fraud and Abuse: University of Washington Professor Sentenced for Health Care Billing Fraud

Seattle - A federal judge on Sept. 25 sentenced a University of Washington professor to five years of probation and 1,000 hours of community service for fraudulent health care billing, according to federal prosecutors (United States v. Couser, W.D. Wash., No. CR03-0145, 9/25/03).

In addition, Judge Robert Lasnik of the U.S. District Court for the Western District of Washington sentenced William G. Couser, a nephrologist and professor at the university's school of medicine, to pay $100,000 in restitution for fraudulent claims, according to the U.S. attorney's office.

BNA's Health Care Daily Report - September 29, 2003

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3. CMS Announces Web-Based Manual

Beginning October 1, 2003, CMS will transition from a paper-based manual system to a Web-based system. The process includes the streamlining, updating , and consolidating of CMS' various program instructions into an electronic Web-based manual system for all users. The new system is called the online CMS Manual System and is located at http://www.cms.hhs.gov/manuals. The new online CMS Manual System will be organized by functional area (e.g., eligibility, entitlement, claims processing, benefit policy, program integrity). The functional orientation of the new manual will eliminate significant redundancy within the manuals and will streamline the updating process, thus making CMS program instructions available in a more timely and accessible fashion.

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4. Court Decision Provides Some Relief on False Claim Cases

In United States v. Medica-Rents Company, 2003 U.S. Dist. LEXIS 16740, the federal district court for the Northern District of Texas rejected the government's position that almost any incorrect claim is a false claim. Describing the Medicare regulations as "among the most completely impenetrable texts within human experience, " the court rejected the government's strict liability theory and accepted the Medica-Rents' good faith defense.