Eric B. Gordon, MD
Subscribe to Eric B. Gordon, MD's PostsEric B. Gordon advises clients on fraud and abuse and compliance issues and health care transactions. He is partner-in-charge of the California Health Industry Practice Group. Eric represents a wide range of clients, including proprietary and tax-exempt hospital systems, medical groups, academic medical centers and faculty practice groups, pharmaceutical companies and medical device manufacturers, and group purchasing organizations. Read Eric B. Gordon's full bio.
OIG Seeks Comments on Anti-Kickback Statute and Beneficiary Inducements as Part of its Regulatory Sprint to Coordinated Care
By Joan Polacheck, Monica Wallace, Tony Maida, Amy H. Kearbey, Daniel H. Melvin, Eric B. Gordon, MD and Jason B. Caron on Aug 27, 2018
Posted In Anti-Kickback Statute / Stark Law, Compliance Developments
On August 24, 2018, the Office of Inspector General (OIG), Department of Health and Human Services (HHS) published a request for information, seeking input from the public on potential new safe harbors to the Anti-Kickback Statute and exceptions to the beneficiary inducement prohibition in the Civil Monetary Penalty (CMP) Law to remove impediments to care...
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CMS Seeks Comments on Stark Law Reforms Needed to Reduce Obstacles to Innovation
By Kelsey Leingang, Monica Wallace, Tony Maida, Amy H. Kearbey, Daniel H. Melvin, Eric B. Gordon, MD and Joan Polacheck on Jul 3, 2018
Posted In Stark
On June 25, 2018, the Centers for Medicare and Medicaid Services (CMS) published a request for information, seeking input from the public on how to address any undue regulatory impact and burden of the physician self-referral law (Stark Law) on value-based and other coordinated care arrangements designed to improve quality and lower cost. While the...
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Congress Examining Stark Law Reform This Year
By Amanda Enyeart, Daniel H. Melvin and Eric B. Gordon, MD on Jul 19, 2016
Posted In Anti-Kickback Statute / Stark Law, Government investigation, Stark
On July 12, 2016, the US Senate Finance Committee held a hearing to “examine ways to improve and reform the Stark Law” as a follow up to releasing a white paper on June 30 titled Why Stark, Why Now? Suggestions to Improve the Stark Law to Encourage Innovative Payment Models. The white paper summarizes comments...
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Health System Practice ‘Losses’ Make Headlines, Plaintiffs Make New Stark ‘Law’
By Daniel H. Melvin and Eric B. Gordon, MD on Nov 25, 2015
Posted In Stark
Health systems routinely employ physicians, either directly or through corporate affiliates. Media reports and anecdotal evidence suggest such practices routinely, perhaps uniformly, result in net practices losses for the system when measured solely based on physician practice revenues. Does this fact have any legal import under the Stark Law? Read the full article from Bloomberg BNA...
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Deconstructing Tuomey: 25 Years on, Is It Time for Congress to Revisit the Stark Law?
By Daniel H. Melvin and Eric B. Gordon, MD on Sep 14, 2015
Posted In Anti-Kickback Statute / Stark Law, Knowledge/Scienter, Stark
In 1989, Congress enacted the Ethics in Patient Referrals Act. Twenty-five years later, in United States ex rel. Drakeford v. Tuomey, the Fourth Circuit upheld the largest False Claims Act (FCA) judgment predicated on Stark Law violations to date: $237 million. Writing in concurrence, Judge Wynn summarized the situation as “[a]n impenetrably complex set of...
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CMS Proposes Stark Law Amendments, Requests Comments on Whether Stark Law Is Barrier to Health Care Reform
By Amanda Enyeart, Amy H. Kearbey, Adam Marks, Daniel H. Melvin, Eric B. Gordon, MD, Joan Polacheck and Tony Maida on Jul 22, 2015
Posted In Stark
The Centers for Medicare & Medicaid Services (CMS) recently published a notice of proposed rulemaking to amend its regulations implementing and interpreting the Stark Law. CMS also used this proposed rule to state its positions on certain questions of Stark Law interpretation and application, and to solicit comments from the industry on whether the Stark...
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Tuomey’s Appeal of $237M False Claims Act Judgment Denied by the Fourth Circuit
By Daniel H. Melvin, Eric B. Gordon, MD, Tony Maida and T. Reed Stephens on Jul 10, 2015
Posted In Stark
The US Court of Appeals for the Fourth Circuit affirmed the trial court’s May 2013 decision that Tuomey Healthcare System, Inc., a hospital and health system based in Sumter, South Carolina, submitted 21,730 false claims, claims prohibited by the Stark Law, to the Medicare program. The court rejected Tuomey’s request for a new trial based on...
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Recent DOJ and OIG Actions Show Growing Federal Scrutiny of Physician Financial Arrangements
By Daniel H. Melvin, Eric B. Gordon, MD, Jason B. Caron, Joan Polacheck and Tony Maida on Jul 1, 2015
Posted In Compliance Developments
Over the last month the Office of Inspector General (OIG) of the Department of Health and Human Services and the Department of Justice (DOJ) have each taken actions that suggest an increasing appetite to examine the financial relationships between physicians and recipients of those physicians’ referrals under the federal Anti-Kickback Statute (AKS). By announcing new...
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Court Upholds CMS’ Prohibition on ‘Under-Arrangements’ Transactions, Strikes Down CMS’ Prohibition on ‘Per-Click’ Equipment Rental Arrangements
By Daniel H. Melvin, Eric B. Gordon, MD, Jason B. Caron and Tony Maida on Jun 19, 2015
Posted In Stark
A 2008 rule change from the Centers for Medicare and Medicaid (CMS)—which effectively prohibited referring physician-owned companies from furnishing hospital services “under arrangements”—has withstood a challenge by a urology trade association. On June 12, 2015, the U.S. Court of Appeals for the District of Columbia Circuit (D.C. Circuit) held that the 2008 rule change, which...
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Fraud Enforcement Trends for 2015: Over the Horizon
By Ankur J. Goel, Daniel H. Melvin, Eric B. Gordon, MD, Jason B. Caron, Joan Polacheck, Laura McLane, Michael W. Peregrine, Tony Maida and T. Reed Stephens on Feb 18, 2015
Posted In Other Notable Enforcement Actions
Health care fraud enforcement continues to be a priority for the federal government and is poised to expand even more. As a result, health care providers and suppliers should anticipate greater oversight activities from auditors and investigators. Ensuring that your compliance program is up-to-date and up-to-task in proactively identifying problems and making timely decisions about...
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