Meet the Co-chairs - TAGLAW
Conner & Winters, LLP
Authors: David J. Edquist, Stacy C. Gerber Ward & Daniel J. Balk III
Author: Richard Y. Cheng
A physician certification for Medicare coverage for ambulance services is not the final word. An ambulance service also must demonstrate the beneficiary’s condition and establish medical necessity when transporting the Medicare beneficiary. In a recent Southern District of Texas decision, the Court affirmed a decision by the Department of Health and Human Services (“HHS”) to deny payment to an ambulance service that provided repeated non-emergency transport to a Medicare beneficiary when the service failed to show that transportation by another means was contraindicated by the patient’s condition.
Medicine has been defined by the World Health Organization as “products that are used to change or analyze physiological and pathological circumstances to the benefit of the user.” Under Turkish law, medicine corresponds to “substance or a combination of substances of natural and/or synthetical origin applied to humans to cure a disease and/or prevent, to make a diagnosis or to restore, regulate or change a function.”
Under the contract terms, Popa & Associates provides legal assistance in gathering information and elaborating technical documentations, developing the business plan, negotiations with public authorities regarding licenses and permits that are necessary to realize the mentioned project, giving a complex legal consultancy throughout the project, implemented with its support and assistance.
Introduction of the public-private partnership (“PPP”) method in the healthcare sector in Turkey has already significantly affected growth of the healthcare sector in the last few years, and new wave of PPP projects over the next five years is expected to be the main driver of expansion in the healthcare services sector. In healthcare PPP projects, the project companies undertake the implementation of the health campus PPP project by executing a private law implementation agreement (i.e., the project agreement) with the Ministry of Health (“MoH”), and the MoH agrees to make certain payments in return. Such payments are used for the repayment of the loans obtained for the project and expenditures of the projects.