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4 Feb 2023, 8:12 am
This case was investigated by the Cleveland FBI, the Office of Inspector General (OIG) for the United States Department of Health and Human Services (HHS), and the Ohio Attorney General’s Healthcare Fraud Section. [read post]
4 Feb 2023, 8:12 am
This case was investigated by the Cleveland FBI, the Office of Inspector General (OIG) for the United States Department of Health and Human Services (HHS), and the Ohio Attorney General’s Healthcare Fraud Section. [read post]
4 Feb 2023, 3:20 am
OCR used its February 2 announcement of the Banner Health settlement to warn health plans, health care providers, health care clearing houses (“covered entities”) and business associates covered by HIPAA to guard their own system containing protected health information against breach by cyber hacking even as the Department of Labor and other agencies are stepping up their cybersecurity rules, oversight and enforcement. [read post]
3 Feb 2023, 1:46 pm
Treasury Department Regulations. [read post]
2 Feb 2023, 1:45 pm
For these years, CMS will limit payment recoveries to “enrollee-level adjustments,” i.e., the non-extrapolated overpayments identified in CMS RADV audits and Department of Health and Human Services Office of Inspector General (OIG) audits. [read post]
31 Jan 2023, 7:59 am
On January 13, 2023, the Department of Justice announced a settlement with DePuy Synthes Inc for $9.75 million. [read post]
31 Jan 2023, 4:05 am
Yesterday, the Department of Health and Human Services along with several other federal agencies filed a 147-page release (full text) proposing rule changes to the Trump Administration's exemptive rules under the Affordable Care Act for employers and universities with objections to furnishing employees and students coverage for contraceptive services. [read post]
30 Jan 2023, 5:00 am
As several of the Department’s stated priorities have not changed since February 2022, providers can expect to see continued enforcement action in areas such as opioid abuse, Medicare managed care (Part C), and audits looking for allegedly medically unnecessary services. [read post]
25 Jan 2023, 7:03 pm
Terminating the healthcare provider’s medicare provider agreement. [read post]
24 Jan 2023, 11:46 am
When administered in an inpatient setting, the drug generally is not separately reimbursable by a federal health care program because it is usually covered under Medicare Part A. [read post]
23 Jan 2023, 10:40 am
These include fraud against government Health Care programs such as Medicare, Medicaid, and TRICARE. [read post]
22 Jan 2023, 3:37 am
The Department of Justice announced on January 20 that a subsidiary of the orthopedic device company DePuy had agreed to pay nearly $10 million to settle a whistleblower’s charges that the company paid kickbacks to a Massachusetts surgeon. [read post]
19 Jan 2023, 10:34 am
If Biden agreed to move all of Social Security, Medicare, and Medicaid spending onto the "discretionary" budget, what would Republicans do? [read post]
18 Jan 2023, 11:43 am
While both are in place to control problematic financial incentives in the health care industry, here are five differences between Stark and AKS: Stark is regulated by the Centers for Medicare & Medicaid Services (“CMS”) while the AKS is regulated by the Office of the Inspector General (the “OIG”) for the Department of Health and Human Services. [read post]
17 Jan 2023, 11:09 am
Utilization Management Requirements Including Prior Authorizations The prior authorization requirements of MAOs have been the focus of a report by the Department of Health and Human Services Office of Inspector General as well as another recent proposed rule by CMS. [read post]
16 Jan 2023, 6:55 pm
COLOPLAST CORP., et al., Appellees. 3rd District.Torts -- Self-incrimination -- Stay of proceedings -- Appeals -- Certiorari -- Civil action brought against two police officers in their individual capacities while criminal proceedings against plaintiff were ongoing -- Trial court departed from essential req [read post]
13 Jan 2023, 11:00 am
The OCD’s goals are to promote balanced, consistent, fair, and transparent regulation of the oil and gas industry, to prevent the waste of oil and gas resources within the state, to protect the correlative rights of resource owners, to foster efficient development, and to protect human health and the environment. [read post]
12 Jan 2023, 9:05 pm
Department of Health and Human Services Secretary Xavier Becerra praised the action, stating that the agency will be “transparent and aggressive in implementation every step of the way. [read post]
11 Jan 2023, 6:00 am
The Department of Justice recently announced two settlements of cases alleging medical device fraud. [read post]
9 Jan 2023, 5:31 am
” With such an endorsement, the alphabet soup of the federal government, departments, and independent agencies—including the Federal Communications Commission for telecoms, the Centers for Medicare and Medicaid Services for hospitals receiving Medicare and Medicaid payments, the Environmental Protection Agency for drinking water systems, and on and on—should acknowledge the cyber risk their sectors face and propose legislation to expressly add… [read post]
