Kevin Fairlie will be presenting at the Georgia Emergency Medical Services Association Directors and Leadership Conference in May. He will be discussing Employment Law issues as well as presenting on the new Medicare Cost Reporting requirements for EMS organizations.
Significantly, 2020 saw the largest number of new FCA cases initiated in a single year. Strikingly, the number of government-initiated cases against health care entities more than doubled from 2019 to 2020 and was at the highest level ever reported.
Qui Tam (Whistleblower) Cases Continue to be the Driver.
Although we continue to see an increase in investigations based on random Medicare audits and internal Medicare reviews of your billing statistics, Whistleblower cases are still your biggest risk by a significant measure. Remember, the FCA allows one of your employees (or multiple employees) to file an allegation of fraud against your organization. If the government intervenes and is successful, the Whistleblower typically receives in the neighborhood of 20% of the total recovery. With most FCA cases having settlements involving millions of dollars, this is obviously a big incentive for disgruntled employees.
To that point, total recoveries from Whistleblower actions generated almost $1.7 billion in 2020. More than $309 million in Whistleblower share awards were paid in FY 2020. The full DOJ report can be found here.
Kevin Fairlie is the guest on Fire Law Blog to discuss the CARES Act and provider relief funding to Fire and EMS agencies.
Kevin joins attorney Curt Varone for a Vlog and podcast at Fire Law. The two discuss the compliance implications of the stimulus money deposited into most Fire and EMS agency bank accounts. Watch and listen to the Vlog/Podcast at Fire Law Blog.
Fire Law Blog's Curt Varone Discusses Medicare and DOJ/OIG Investigations into Fire Based EMS with Kevin Fairlie
A big thank you to Curt Varone at Fire Law Blog for hosting Kevin Fairlie to discuss DOJ/OIG federal investigations into Fire Based EMS for False Claims Act violations and steps Fire Departments should take to avoid scrutiny.
"In today’s episode, Curt talks with attorney Kevin Fairlie about the challenges facing fire departments who bill for EMS transports. Kevin’s law practice concentrates on health care related topics, but a recent spate of federal investigations across the country into fire department EMS billing practices has led him to represent numerous fire departments." You can hear their entire podcast discussion at Fire Law Blog, Podcast 30: EMS Billing and Medicare Medicaid Fraud.
Kevin Fairlie Publishes a Number of Articles on the Implication of Medicare's new Cost Reporting Requirements on EMS
Based on his years of experience with Medicare cost-reporting and his deep understanding of the EMS industry, our Managing Member, Kevin Fairlie, has been asked to write a number of articles recently on Medicare's new cost-reporting requirements for the EMS industry as well as state specific Medicaid cost reporting requirements.
Examples of these articles can be found in the Fall 2019 Missouri EMS Association (MEMSA) EMS Connection magazine and the Kansas EMS Association (KEMSA) Chronicle magazine.
More articles with current updates on this evolving topic are set for publication in other state EMS association journals and we will update you with those articles as they are published!
Founding Member, Kevin Fairlie, Speaks about Compliance Issues and DOJ/OIG Investigations at Pinnacle EMS 2019
This is a snippet of what EMS World had to say about Kevin's presentation:
"Accusations of false claims and negligence can send shivers down the spines of even the most careful EMS administrators. During “2019 Legal Update” at Pinnacle July 26, two experienced EMS attorneys brought attendees up to speed on current EMS case law and how providers and agencies can protect themselves."
The entire EMS World article can be found here: https://www.emsworld.com/article/1223025/pinnacle-ems-case-law-are-you-protected
From the May 2, 2019 Department of Justice Press Release: A 46-year-old Houston man has been ordered to federal prison following his conviction of conspiracy to commit health care fraud, announced U.S. Attorney Ryan K. Patrick. Full Press Release can be found here www.justice.gov/usao-sdtx/pr/ambulance-owner-sent-prison-health-care-fraud
Kevin Fairlie contributes article discussing the ongoing DOJ investigations into fire-based EMS Services.
The article appears in the May 3, 2018 issue of the Paramedic Chief Leadership Briefing. Please follow the link to the Paramedic Chief Leadership Briefing to learn more about how, for the past two years, the Department of Justice, through its local U.S. Attorney offices, along with the Department of Health and Human Services’ Office of Inspector General, has been actively investigating fire-based services for improperly billing Medicare for ALS ambulance transports when a BLS level service should have been billed.
Firm founding member, Kevin Fairlie, will be presenting the annual update at this year's premiere EMS conference for the nation's EMS leaders - Pinnacle 2018
Follow the link here to register for Pinnacle 2018 and participate in its many leaderships sessions including the Legal Update described as : "Each year Pinnacle addresses current legal issues, recent cases and legal strategies for EMS leaders. This session will cover new developments in EMS and healthcare law, including new regulations, medical decision-making, risk management, workplace conduct, healthcare compliance and other timely topics."
Kevin Fairlie will be Presenting at the Missouri Association of Fire Chiefs' Winter Conference at Big Cedar Lodge on February 23rd and 24th
Mr. Fairlie will lead a 3 hour discussion covering the increased scrutiny of fire based EMS services by the DOJ and OIG as it relates to Medicare fraud as well as the changing reimbursement landscape for EMS providers. More information can be found at the Missouri Association of Fire Chiefs website.