ries to stand without reduction.24This article was originally published in theTrial Advocate,Volume 42, No 1, a publication of theFlorida Defense Lawyers Associationand is republished here with permission.176 So. 3d 1247 (Fla. 2015).2 Id. at 1257.868 So. 2d 547 (Fla. 4th DCA 2003).4 872 So. 2d 956 (Fla. 2d DCA 2004).Thyssenkrupp, 868 So. 2d at 549.Id. at 550 (citing Cooperative Leasing Inc. v. Johnson, 872 So. 2d 956(Fla. 2d DCA 2004)).452 So. 2d 514 (Fla. 1984.)B 392 N.E.2d 1 (III. 1979).9 Thyssenkrupp, 868 So. 2d at 550 (citing Stanley, 452 So. 2d at 515).1° 337 So. 3d 1229 (Fla. 2022).11 Id. at 1230.12 Dial v. Calusa Palms Master Ass’n, 308 So. 3d 690, 692 (Fla. 2d DCA 2020).13 337 So. 3d at 1231.14 42 U.S.C. §§ 1395-1395i-4 (citing Stewart v. Sullivan, 816 F. Supp. 283, 284 (D.N.J. 1992).15 42 U.S.C. §§ 1395j-1395w-4 (citing Stewart v. Sullivan, 816 F. Supp. 283, 284 (D.N.J. 1992).16 42 U.S.C. §§ 1395u(b)(4).17 Stewart, 816 F. Supp. At 284.18 Id.19 42 U.S.C. §§ 1395w-4(g)(4)(A).20 42 U.S.C. §§ 1395(b)(2)(a)(i).21 42 U.S.C. §§ 1395(b)(3)(B).22 42 CFR § 405.430(b).23 United Senators Ass’n v. Shalala, 182 F.3d 965, 969 (D.C. Cir. 1999).24 Thyssenkrupp, 868 So. 2d at 550

Regarding What Constitutes a Reckless Interpretation of a Law and When Retention of an Overpayment Violates the False Claims ActFebruary 25, 2016 -What Must the Government Prove to Establish that a Defendant Recklessly Interpreted a Statute or Regulation in Violation of the False Claims Act?December 21, 2015 -Understanding When An Overpayment Can Result in False Claims Liability and Why Current Court Precedent and Regulatory Guidance Is MistakenOctober 28, 2015 -Minimizing Exposure to Stark Law Liability in False Claims Act Cases by Isolating Those Who Determine Fair Market Value From Those Who Measure Contribution Margin or Other Similar Operational DataOctober 1, 2015 -When a Violation of a Rule or Regulation Becomes an FCA Violation: Understanding the Distinction Between Conditions of Payment and Conditions of ParticipationSeptember 25, 2015 - False Claims Act Public Disclosure AlertNo. 16-13004, 2019 U.S. App. LEXIS 27074 (11th Cir. Sept. 9, 2019).Id. at *11-12.Id. at *5 (quoting 42 U.S.C. § 1395(7)(A)).Id. (quoting 42 U.S.C. § 1395(dd)(3)(A)).Id. at *36 (quoting 75 Fed. Reg. 70372, 70448 (Nov. 17, 2010)). See also 79 Fed. Reg. at 50470 (“[W]e also have recognized the challenges in prognostication” and therefore expect “that the certifying physicians will use their best clinical judgment.”).Id. at 36.Id.Id. at *39.

But the Act also includes specific provisions benefiting telehealth and remote patient monitoring (RPM), particularly for the Medicare program. It states:Telehealth and remote patient monitoring are expressly recognized as, and included in the definition of, “Clinical Practice Improvement Activities” along with care coordination, population health management, and monitoring of health conditions.New “Alternative Payment Models” may include payment for telehealth services, even if the service is not otherwise covered by the traditional Medicare program (42 U.S.C. 1395(m)).The GAO is required to conduct a study on telehealth and the Medicare program, publishing the report no later than April 2017.

6001.Physician and Hospital Disclosures § 1877(i)(1)(C) [42 U.S.C. § 1395(i)(1)(C)] CMS issued final regulations on Nov. 24, 2010 (75 Fed. Reg. 71,800).

care hospital, acute psychiatric hospital, or the parent entity of a general acute care hospital or acute psychiatric hospital;A psychiatric health facility, as defined in Section 1250.2;A mental health rehabilitation center, as defined in Section 5675 of the Welfare and Institutions Code;A community clinic licensed under Section 1204(a), an intermittent clinic exempt from licensure under Section 1206(h), or a clinic operated by the state or any of its political subdivisions, including—but not limited to—the University of California or a city or county that is exempt from licensure under Section 1206(b);A rural health clinic, as defined in 42 U.S.C. 1396d(l)(1);An urgent care clinic (i.e., a facility or clinic that provides immediate, nonemergent ambulatory medical care to patients, including—but not limited to—facilities known as walk-in clinics or centers or urgent care centers);An ambulatory surgical center that is certified to participate in the Medicare Program under Title XVIII (42 U.S.C. Sec. 1395, et seq.) of the federal Social Security Act;A physician group (i.e., a medical group practice, including a professional medical corporation, as defined in Section 2406 of the Business and Professions Code, another form of corporation controlled by physicians and surgeons, or a medical partnership, provided that the group includes a total of 25 or more physicians);A county correctional facility that provides healthcare services; andA county mental health facility.“Health care services” is also defined broadly to mean patient care-related services, including: nursing; caregiving; services provided by medical residents, interns or fellows; technical and ancillary services; janitorial work; housekeeping; groundskeeping; guard duties; business office clerical work; food services; laundry; medical coding and billing; call center and warehouse work; scheduling; and gift shop work; but only where such services support patient care.SB 525 does not cover hospitals owned, controlled or operated

ges from the original NJ WARN, and some seemingly unresolved issues under the amendments.APRIL 14, 2020 AMENDMENTS EFFECTIVE MARCH 9, 2020The following amendments were made effective as of March 9, 2020.Adding a Natural Disaster Exception: During the COVID-19 crisis, there were numerous questions about what events trigger notice, what excuses late notice, or whether COVID-related losses are exempt from notice under FED WARN and NJ WARN. There were also many questions about the potential impact of the previously adopted January 21, 2020 amendments. The April 14, 2020 amendments included a significant addition to NJ WARN (retroactive to March 9, 2020) by creating a new exemption from the statute for mass layoffs caused by “a fire, flood, natural disaster, national emergency, act of war, civil disorder or industrial sabotage, decertification from participation in the Medicare and Medicaid programs as provided under Titles XVIII and XIX of the federal "Social Security Act," Pub.L. 74-271 (42 U.S.C. s.1395 et seq.) or license revocation pursuant to P.L.1971, c.136 (C.26:2H-1 et al.).” This natural disaster/national emergency exemption was made applicable to both a termination of operations and for a mass layoff.JANUARY 21, 2020 AMENDMENTS EFFECTIVE 90 DAYS AFTER JANUARY 10, 2023The following are the additional changes to NJ WARN that will go into effect on April 10, 2023.Definition of Employer:There actually are at least two definitions of “employer” in the amended statute, which may create confusion. The first definition remains unchanged and states that an “employer” is “an individual or private business entity which employs the workforce at an establishment.” The second definition of “employer,” which is new and which appears in Section 2d of the statute, states that for purposes of potential liability for failing to perform any of the required acts (e.g., give notice, pay base or penalty severance, or notify the response team), an “employer” includes:“any individual, partnership, as

ere at Camp Lejeune between August 1, 1953, and December 31, 1987, for 30 days or more (both consecutive and non-consecutive days) are eligible to file suit. This includes veterans, family members, non-military workers (civilian contractors), and any others (in utero) who were exposed to the contaminated water between the listed dates.What isn't as obvious—and what we hope to clarify here—is if and how filing suit under the Justice Act may impact the continued receipt of other government benefits.The pertinent provision of the Justice Act reads:(2) Health and disability benefits relating to water exposure--Any award made to an individual, or legal representative of an individual, under this section shall be offset by the amount of any disability award, payment, or benefit provided to the individual, or legal representative--(A) under--(i) any program under the laws administered by the Secretary of Veterans Affairs;(ii) the Medicare program under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.); or(iii) the Medicaid program under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.); and(B) in connection with health care or a disability relating to exposure to the water at Camp Lejeune.PACT Act § 804(e)(2).Let's unpack this. At its core, the provision is designed to prevent double dipping, i.e., allowing an individual to recoup twice for the same injury. Thus, when it is implicated, the provision will serve to reduce or offset any eventual monetary award by the sum of government benefits already received for related health or disability issues.What it does not do is prohibit or prevent any exposed individual (or their legal representative) from filing a lawsuit in the first instance. Nor does it jeopardize the continued receipt of related government benefits.In fact, several things must be true for the provision to be triggered. First, this provision only applies if an individual has already been receiving government benefits in connection with health care o

ere at Camp Lejeune between August 1, 1953, and December 31, 1987, for 30 days or more (both consecutive and non-consecutive days) are eligible to file suit. This includes veterans, family members, non-military workers (civilian contractors), and any others (in utero) who were exposed to the contaminated water between the listed dates.What isn't as obvious—and what we hope to clarify here—is if and how filing suit under the Justice Act may impact the continued receipt of other government benefits.The pertinent provision of the Justice Act reads:(2) Health and disability benefits relating to water exposure--Any award made to an individual, or legal representative of an individual, under this section shall be offset by the amount of any disability award, payment, or benefit provided to the individual, or legal representative--(A) under--(i) any program under the laws administered by the Secretary of Veterans Affairs;(ii) the Medicare program under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.); or(iii) the Medicaid program under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.); and(B) in connection with health care or a disability relating to exposure to the water at Camp Lejeune.PACT Act § 804(e)(2).Let's unpack this. At its core, the provision is designed to prevent double dipping, i.e., allowing an individual to recoup twice for the same injury. Thus, when it is implicated, the provision will serve to reduce or offset any eventual monetary award by the sum of government benefits already received for related health or disability issues. What it does not do is prohibit or prevent any exposed individual (or their legal representative) from filing a lawsuit in the first instance. Nor does it jeopardize the continued receipt of related government benefits. In fact, several things must be true for the provision to be triggered. First, this provision only applies if an individual has already been receiving government benefits in connection with health care

Although the 2023 proposed OPPS rule should be released soon, it likely will be months, if not years, and possibly more litigation, before the full impact of the decision is known. Medicare Prescription Drug, Improvement and Modernization Act of 2003, 117 Stat. 2066, 42 U.S.C. § 1395(l)(t)(14)

Indeed, the Court recognized that Congress has authorized the Secretary to impose conditions on the receipt of Medicaid and Medicare funds that “the Secretary finds necessary in the interest of health and safety of individuals who are furnished services.” (citing 42 U.S.C. §1395(e)(9)). The Court’s ruling hinged, in part, on the unique nature of health care settings.