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Experience Spotlight

Primary Care Providers Win Challenge of CMS Interpretation of Enhanced Payment Law

With the help and support of the Tennessee Medical Association, 21 Tennessee physicians of underserved communities joined together and retained Bass, Berry & Sims to file suit against the Centers for Medicare & Medicaid Services to stop improper collection efforts. Our team, led by David King, was successful in halting efforts to recoup TennCare payments that were used legitimately to expand services in communities that needed them. Read more

Tennessee Medical Association & Bass, Berry & Sims

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Thought Leadership

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Download the Healthcare Fraud & Abuse Review 2017, authored by Bass, Berry & Sims

The Healthcare Fraud & Abuse Review 2017 details all healthcare-related False Claims Act settlements from last year, organized by particular sectors of the healthcare industry. In addition to reviewing all healthcare fraud-related settlements, the Review includes updates on enforcement-related litigation involving the Stark Law and Anti-Kickback Statute, and looks at the continued implications from the government's focus on enforcement efforts involving individual actors in connection with civil and criminal healthcare fraud investigations.

Click here to download the Review.

Successful Defense for SDVO Small Business

Client Type: Private Company

The Government Contracts team successfully defended a service-disabled, veteran-owned small business (SDVOSB) in a size appeal filed at the SBA's Office of Hearings and Appeals (OHA). BES Design/Build, a VA certified SDVOSB, was the successful awardee of a contract issued by the Department of Veterans Affairs to upgrade fire sprinkler systems at the VA Medical Center in Memphis, Tennessee. A disappointed bidder protested the award, arguing that BES was not a small business under the $14 million size standard for the procurement at issue.

In its protest, the disappointed bidder argued that BES was affiliated with several other companies, and the combined revenue of all BES affiliates exceeded the procurement's $14 million size standard. The protester alleged that BES shared common management with another company by virtue of a mentor-protégé agreement, and with additional companies owned by BES's minority member. In response, BES presented evidence to the SBA showing that the majority owner of BES was a service-disabled veteran in complete control of the company. Further, BES certified that its majority owner did not have any management authority in any of the alleged affiliates.

The SBA area office determined that because no other individual or company could control BES, and BES did not have control over any other company, there was no affiliation to be found. Thus, the SBA determined that BES was a small business and denied the protest. Unsatisfied, the disappointed bidder filed an appeal with OHA challenging the SBA size determination. In its appeal, the disappointed bidder made additional allegations of affiliation not raised in the original protest. 

We argued against the inclusion of the new allegations, on the basis that protesters are not permitted to introduce new grounds of protest in an appeal. In addition, we argued that even if the new affiliation allegations were properly raised, the evidence clearly showed that BES was not affiliated with any of the companies alleged as affiliates by the protester. OHA agreed, and denied the appeal. As a result, BES maintained its SDVOSB status and the VA was able to move forward with the award to BES.

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