Overview 2012. A year of dialysis industry alignment and government enforcement.

All in all, in the health care industry, the Department of Justice, and related agencies increased enforcement activities in 2012. In December 2012 the Justice Department announced that it had secured $4.9 billion in settlements and judgments in civil cases involving fraud against the government in the fiscal year ending September 30, 2012. This figure is a record recovery for a single year, eclipsing the previous record by more than $1.7 billion. While this activity increased, in many False Claims Act cases, including those noted above in which the courts reached the merits of the cases, health care providers had some victories, including successful results at the trial and appellate levels. As a result, providers may take some comfort that the judicial skepticism towards the most aggressive False Claims Act prosecutions may be growing, and with it, the likelihood of providers' success in certain cases.

Medicare recovery audit contractors: what providers need to know and how to prepare.

RAC audits are on their way in 2009 and all providers should strive to be prepared. In a depressed economy in which most providers are experiencing decreased or stagnating reimbursement, an additional hit to the bottom line from a RAC audit is especially unwelcome. Providers have a number of tools at their disposal, however, to proactively prepare in advance of receiving a RAC demand letter or medical record request.

Dialysis facility joint ventures--current structures and issues.

With the ongoing consolidation of the health care industry, including renal care, providers and physicians alike are using joint ventures as a means to partner on business transactions. This article discusses the expanding use of joint ventures in health care, including the dialysis industry, and looks at the types of structures being utilized and key legal concerns relating to such structures and issues.