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19 May 2022, 2:02 pm
Unlike in other industries, when health care companies pay commissions to independent sales representatives in exchange for referrals of patients covered by Medicare or other Federal health care programs, they violate the anti-kickback statute (AKS), 42 U.S.C. [read post]
16 May 2022, 5:00 am
The Department of Health and Human Services (HHS) Office of Inspector General (OIG) recently took note of some of the issues providers are having with MA plans and may present a new avenue for providers dealing with these issues. [read post]
15 May 2022, 9:11 pm
July 6, 2021 | Ending the Long Wait for Federal Guidance on Reopening Schools | The Education Department’s COVID-19 guidance may signal a return to information sharing. [read post]
12 May 2022, 6:59 am
The Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) and the Office of Inspector General (OIG) are actively providing audit support, technical assistance, and investigative coordination to the states’ fraud-fighting efforts. [read post]
6 May 2022, 12:10 pm
The DOJ highlighted health care fraud as “the leading source of the department’s False Claims Act settlements and judgments. [read post]
2 May 2022, 2:12 pm
The Supreme Court took notice that Premier Rehab was subject to these laws because its receipt of Medicare and Medicaid payments qualified as federal financial assistance triggering their applicability. [read post]
30 Apr 2022, 12:02 pm
Interestingly, under 768.76(2)(b), “Medicare, or any other federal program providing for a Federal Government lien on or right of reimbursement from the plaintiff’s recovery, the Workers’ Compensation Law, the Medicaid program of Title XIX of the Social Security Act or from any medical services program administered by the Department of Health shall not be considered a collateral source. [read post]
29 Apr 2022, 6:48 am
Court of Appeals for the Eleventh Circuit upheld the rule requiring vaccines for workers at Medicare- and Medicaid-supported hospitals, also issued under the exception. [read post]
27 Apr 2022, 9:15 am
Department of Human Services and the Centers for Medicare and Medicaid Services (CMS). [read post]
26 Apr 2022, 1:35 pm
Springbok Health Inc. [read post]
26 Apr 2022, 12:12 pm
Rivers will the provide updates on the health plan eligibility, COVID emergency orders, surprise billing, mental health parity and other Department of Labor regulatory, compliance, audit, enforcement priorities and other health plan projects and developments. [read post]
26 Apr 2022, 11:48 am
The Health Insurance Marketplaces 2022 Open Enrollment Report (“Report”) published by the Centers for Medicare and Medicaid Services last month reveals the 2022 Open Enrollment Period (“2022 OEP”) produced the highest enrollment in health care marketplace plans since passage of the Patient Protection and Affordable Care Act (“ACA”) 12 years ago. [read post]
25 Apr 2022, 12:08 pm
The [Department of Health and Human Services’ Office for Civil Rights] OCR breach portal now reflects this more clearly. [read post]
25 Apr 2022, 5:00 am
The Department of Health and Human Services (HHS) has also announced additional audits of certain healthcare providers that received funding from the Provider Relief Fund (PRF). [read post]
21 Apr 2022, 9:52 am
The Department of Justice has highlighted its enforcement efforts in Medicare Advantage fraud, and following our success against Sutter Health, we are especially focused on risk adjustment cases, with several pending matters in which the government has intervened, including actions against Independent Health Association, Kaiser Permanente, and in one of the largest risk adjustment matters ever, against UnitedHealth Group. [read post]
21 Apr 2022, 5:00 am
The Department of Health and Human Services (HHS) Office of Inspector General (OIG) is similarly required to provide Congress with a report by June 15, 2023 on program integrity risks associated with Medicare telehealth services. [read post]
20 Apr 2022, 6:03 pm
According to DOJ’s press release: Springbok Health Inc., a medical clinic with locations in Colorado Springs and Pueblo West, Colorado, and Mark Jankelow, Springbok’s owner and Chief Executive Officer, have agreed to pay at least $125,000, and up to as much as $335,494, to resolve allegations they violated the False Claims Act by billing Medicare and Medicaid for high-complexity and prolonged medical evaluation and management services when such services were… [read post]
20 Apr 2022, 5:55 pm
* * * The company also entered a five-year corporate integrity agreement with the Department of Health and Human Service’s Office of Inspector General. [read post]
19 Apr 2022, 5:05 am
Contents What is the Anti Kickback Statute Key Terms in the Anti Kickback Law AKS Covered Entities Anti-Kickback Statute Safe Harbors Penalties and Enforcement Examples State Anti-Kickback Statutes What is the Anti Kickback Statute The Anti-Kickback Statute is the popular name for The Medicare and Medicaid Fraud and Abuse Statute, 42 U.S.C. [read post]
14 Apr 2022, 9:08 pm
Department of Labor Secretary Marty Walsh announced the Occupational Safety and Health Administration’s (OSHA) first ever program designed to protect workers from extreme heat hazards in the workplace. [read post]
