Search for: "Medicare, Medicaid & Medical Suppliers"
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19 Jul 2017, 2:31 am
Foundations Health Solutions (“FHS”), Olympia Therapy (“Olympia”), and Tridia Hospice Care (“Tridia”), Ohio-based healthcare companies, and their executives, Brian Colleran and Daniel Parker, recently agreed to pay approximately $19.5 million to resolve allegations relating to the the submission of false claims for medically unnecessary therapy and end-of-life hospice services to Medicare and the State of Ohio’s Medicaid program. [read post]
10 May 2017, 10:20 am
While Congress continues to debate the future of the Obamacare health reforms and its exchanges, the Department of Health & Human Services is reminding employers with less than 50 employees that wish to offer group health coverage for their employees to check out their coverage options offered the Small Business Health Options Program (SHOP) Marketplace established as part of the Patient Protection and Affordable Care Act (ACA). [read post]
26 Apr 2017, 6:14 pm
A new Department of Health and Human Services Office of Civil Rights (OCR) CardioNet Resolution Agreement and Corrective Action Plan (Resolution Agreement) settling OCR charges of violations of the Privacy and Security Rules of the Health Insurance Portability & Accountability Act against remote cardiac monitoring provider CardioNet provides important lessons for health plans, health insurers telemedicine and other healthcare providers, healthcare clearinghouses (Covered… [read post]
25 Apr 2017, 3:21 pm
Among other things, group health plans and their fiduciaries can face audits, litigation and enforcement actions by the Centers for Medicare & Medicaid Services and other health plans for improperly coordinating plan claims with other coverage as well as lawsuits from covered persons, their health care providers or other beneficiaries, the Department of Labor and CMS, or others seeking to enforce rights to benefits, penalties in the case of CMS or the Department of Labor,… [read post]
24 Apr 2017, 5:08 pm
Health plans, their fiduciaries and sponsors, health insurers, health care providers, health care clearinghouses (“covered entities”) and their business associates must get and keep your business associate (BA) agreements (BAAs) in place, up- to-date, and readily available for inspection in accordance with the Health Insurance Portability & Accountability Act (HIPAA) Privacy Rule, 45 C.F.R. [read post]
14 Apr 2017, 12:08 pm
Also, CMS has gotten an early start on the calendar year (CY) 2018 rules, with the proposed updates for outpatient hospital departments/ambulatory surgical centers, home health agencies, end-stage renal disease providers, and suppliers of durable medical equipment, prosthetics, orthotics, and supplies all pending at OMB. [read post]
12 Apr 2017, 9:35 pm
Throughout her career, she has helped health industry clients manage workforce, medical staff, vendors and suppliers, medical billing, reimbursement, claims and other provider-payer relations, business partners, and their recruitment, performance, discipline, compliance, safety, compensation, benefits, and training ;board, medical staff and other governance; compliance and internal controls; strategic planning, process and quality improvement; change… [read post]
23 Jan 2017, 8:56 am
Durable Medical Equipment: A North Carolina owner of a DME supplier was ordered to pay $2.6 million in restitution (and sentenced to 3.5 years) in connection with an alleged Medicare fraud scheme involving sham DME companies and purchased lists of individually identifying health information, which were then used to submit false claims. [read post]
23 Jan 2017, 8:56 am
Durable Medical Equipment: A North Carolina owner of a DME supplier was ordered to pay $2.6 million in restitution (and sentenced to 3.5 years) in connection with an alleged Medicare fraud scheme involving sham DME companies and purchased lists of individually identifying health information, which were then used to submit false claims. [read post]
19 Jan 2017, 10:37 am
The statute not only prohibits outright bribes, but also prohibits offering inducements or remuneration that has as one of its purposes the inducement of a physician to refer patients for services that will be reimbursed by a federal healthcare program. prohibits, among other things, the payment of remuneration to induce the use of medical devices covered by Medicare, Medicaid and other federally-funded health care programs, including the Department of Veterans Affairs… [read post]
19 Jan 2017, 10:37 am
The statute not only prohibits outright bribes, but also prohibits offering inducements or remuneration that has as one of its purposes the inducement of a physician to refer patients for services that will be reimbursed by a federal healthcare program. prohibits, among other things, the payment of remuneration to induce the use of medical devices covered by Medicare, Medicaid and other federally-funded health care programs, including the Department of Veterans Affairs… [read post]
29 Dec 2016, 7:43 am
Whether it is providing medical insurance through Medicare or Medicaid, the construction of military weaponry, or a host of other services the government provides, the government’s use of private companies to accomplish these goals is vast. [read post]
21 Dec 2016, 2:08 am
Across the country, corrupt physicians accept cash payments from patients without providing them proper examinations, and some file erroneous or fraudulent claims with private insurance companies and Medicare/Medicaid. [read post]
22 Nov 2016, 12:59 pm
Department of Health and Human Services (HHS) rules that are potentially eligible for disapproval under the CRA as of November 16, 2016, include the following: ONC Health IT Certification Program: Enhanced Oversight and Accountability (Oct. 19, 2016) Medicare And Medicaid Programs; Reform Of Requirements For Long-Term Care Facilities (Oct. 4, 2016) Emergency Preparedness Requirements For Medicare And Medicaid Participating Providers And Suppliers (Sept.… [read post]
21 Nov 2016, 2:46 pm
The Centers for Medicare & Medicaid Services (CMS) has issued its final Medicare physician fee schedule (MPFS) for calendar year (CY) 2017. [read post]
21 Nov 2016, 2:46 pm
The Centers for Medicare & Medicaid Services (CMS) has issued its final Medicare physician fee schedule (MPFS) for calendar year (CY) 2017. [read post]
2 Nov 2016, 4:57 am
Companies in its portfolio include Midcap Financial, healthcare-focused specialty finance company providing asset-based, life sciences, real estate, and leveraged loans to U.S. middle-market companies; Eating Recovery Center, a behavioral health provider specializing in the treatment of eating disorders; and Universal American Corp., a provider of senior Medicare and Medicaid insurance products. [read post]
1 Nov 2016, 10:30 am
As discussed in a separate post, the final rule also adopts a number of provisions impacting Medicare suppliers of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS), including changes to competitive bidding program (CBP) requirements and adjustments to DMEPOS fee schedules based on CBP pricing. [read post]
1 Nov 2016, 10:04 am
CMS has adopted a number of changes to its Medicare durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) policies for 2017, including new competitive bidding program (CBP) requirements and revisions to the methodology for updating Medicare DMEPOS fee schedule amounts based on CBP pricing. [read post]
24 Oct 2016, 1:29 pm
“Medicare will not put the health of its beneficiaries at risk by paying for items that have been ‘reimported’ to this country by foreign suppliers,” said HHS OIG SAC Steven J. [read post]
