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14 Mar 2012, 9:00 am
The Office of Inspector General ("OIG") for the Department of Health and Human Services recently issued an alert, which warned that “physicians who reassign their right to bill the Medicare program and receive Medicare payments by executing the CMS-855R application may be liable for false claims submitted by entities to which they reassigned their Medicare benefits. [read post]
3 Sep 2013, 4:36 pm
Both cases were investigated by the FBI and Department of Health & Human Services-Office of the Inspector General, which was conveyed as a measure of the Medicare Fraud Strike Force. [read post]
24 Mar 2016, 1:47 pm
Department of Health and Human Services Office of Inspector General (HHS-OIG), commented, “We will not stand idly by while Medicare coverage rules are ignored. [read post]
11 Jun 2007, 4:35 pm
The Center for Medicare & Medicaid (CMS) is the component of the Federal Government's Department of Health and Human Services that oversees the Medicare and Medicaid programs. [read post]
18 Oct 2022, 1:45 pm
The DOJ highlighted health care fraud as “the leading source of the department’s False Claims Act settlements and judgments. [read post]
4 Mar 2014, 9:51 am
The Centers for Medicare & Medicaid Services (CMS) has revised its guidance in its Non-Group Health Plan (NGHP) User Guide to clarify the reporting threshold for certain liability (including Self-Insurance) Settlements, Judgment Awards, or other Payments under the provisions of the Medicare Secondary Payer Mandatory Reporting Provisions in Section 111 of the Medicare, Medicaid, and SCHIP Extension Act of 2007, 42 U.S.C. 1395y(b)(7)&(b)(8) (the… [read post]
11 Oct 2016, 8:24 am
Assistant attorney general Leslie Caldwell called it the “largest single criminal health care fraud case ever brought against individuals by the Department of Justice. [read post]
6 Jul 2016, 10:00 am
Pursuant to Sections 1128 and 1156 of the Social Security Act, the US Department of Health and Human Services Office of Inspector General ("OIG") has the authority to exclude individuals and entities from federally funded health care programs, such as Medicare and Medicaid. [read post]
21 Sep 2022, 7:24 am
You must evaluate your current health status, your finances, the terms of your existing plan and available plans. [read post]
23 Mar 2015, 4:31 pm
Medicare: Payment Methods for Certain Cancer Hospitals Should Be Revised to Promote Efficiency, GAO-15-199: Published: Feb 20, 2015. [read post]
13 Oct 2013, 10:05 am
Department of Health and Human Services and the U.S. [read post]
13 Feb 2019, 8:30 am
The US Department of Health and Human Services (HHS) on Monday proposed new rules to improve the interoperability of electronic health information. [read post]
9 Mar 2020, 10:26 am
Under 42 CFR Sec. 424.535(a) (11), CMS can revoke the Medicare billing privileges of a home health agency if within 30 days of CMS or a Medicare contractor request, the home health agency cannot furnish supporting documentation verifying that the home health agency meets the initial reserve operating funds requirement found in 42 CFR Sec. 489.28(a). [read post]
27 Feb 2011, 9:47 am
(February 27, 2011): Thanks to the watchful eyes of the Louisiana Association of Behavioral Health (LABH), a recent notice posted by Louisiana’s Medicare Administrative Contractor (MAC), Pinnacle Business Solutions (Pinnacle) didn’t go unnoticed. [read post]
8 Aug 2016, 8:00 am
Caldwell publicly announced the unsealing of charges in what she called “the largest single criminal health care fraud case ever brought against individuals by the Department of Justice. [read post]
Nursing Homes Should Identify Potentially Preventable Emergency Department Visits by Their Residents
30 Apr 2015, 1:49 pm
Emergency Department (ED) visits and subsequent hospital admissions from nursing homes (NHs) are common and can be costly to the patient and the health care system. [read post]
16 Feb 2012, 7:25 am
Reports indicate that a record $4.1 billion was recovered and returned to Medicare Trust Funds, the Treasury and other departments during 2011. [read post]
27 Mar 2009, 1:58 pm
In doing so, the hospital will resolve claims that it "improperly increased charges to Medicare patients to obtain enhanced reimbursement from the federal health insurance program for the elderly. [read post]
25 Jul 2022, 1:52 pm
In a perhaps final coda to Pfizer’s bizarre attempt to get the government or a court to bless blatant violations of the anti-kickback statute (AKS), the Second Circuit ruled today that the Department of Health and Human Services Office of Inspector General (HHS-OIG) did not err in issuing an unfavorable advisory opinion on Pfizer’s proposed “Direct Copay Assistance Program” (the program). [read post]
16 Nov 2020, 5:18 am
To read more, visit https://www.miamiherald.com/news/health-care/article246919602.html. [read post]
