"Nationwide Healthcare Lawyers"
(March 23, 2015): Last week, the Department of Justice (DOJ) and Department of Health and Human Services (HHS) announced that they had recovered more than $27.8 billion to the Medicare Trust Fund due to the efforts of the Health Care Fraud and Abuse Control Program (HCFAC). As set out in the 2014 HCFAC Report, in […]
2014 HCFAC Report — $27.8 Billion Recovered for Medicare Read More »
(March 6, 2015): As we have seen in recent years, Medicaid audits resulting in dental claims False Claims Act liability are increasing around the country. Earlier this week, the U.S. Attorney’s Office, the U.S. Department of Health and Human Services. Office of Inspector General (HHS-OIG), and the Maine Attorney General’s Office announced the settlement of
Dental Claims False Claims Act Liability Read More »
(March 3, 2015): The federal False Claims Act (FCA), 31 U.S.C. §§ 3729 – 3733 is the primary civil enforcement tool utilized by the U.S. Department of Justice (DOJ). Enacted in 1863, this Civil War era statute was passed by Congress in an effort to address the fraudulent acts of government contractors providing goods and
False Claim Act Whistleblower Cases Are Rising Read More »
(January 22, 2015): Medicaid dental audits have greatly expanded over the past few years. As many (if not all) dentists and orthodontists are painfully aware, the both federal and state law enforcement agencies have doggedly pursued Medicaid dental providers in their efforts to recoup funds paid to dentists and orthodontists for the provision of medically
Medicaid Dental Audits: Exclusion Screening Issues Read More »
(January 21, 2015): Starting this year, the Centers for Medicare and Medicaid Services (CMS) will have three Medicare quality and safety incentive programs go into effect. As a result, a number of hospitals across the U.S. will be penalized more than 3% on most of their CMS reimbursements. I. Medicare Incentive Programs Now in Effect:
New Medicare Incentive Programs Read More »
(December 30, 2014): In a recent webinar presentation, I was asked whether I believed one of the many file sharing services that are available, was adequately encrypted. After investigating some of the particulars, the answer to that question was “yes”, but the answer raised more questions as to what else the Cloud Service Provider (CSP)
Cloud Storage Providers & BAAs – Where is Your Data? Read More »
(August 12, 2014): Texas Medicaid dental fraud has been an ongoing concern of both federal and state law enforcement agencies. As set out in an August 2014 report titled “Texas did Not Ensure that the Prior Authorization Process was Used to Determine the Medical Necessity of Orthodontic Services,” the U.S. Department of Health and Human
Texas Medicaid Dental Fraud: Is the State Partly to Blame? Read More »
(July 30, 2014): In recent years, both the type and the frequency of Medicare and Medicaid audits of health provider and supplier claims have greatly increased. Not surprisingly, these administrative enforcement actions have led to a wide variety of adverse collateral effects, ranging from Medical Board investigations to the initiation of private payor audits. Notably,
Mandatory Compliance Programs for Medicaid & Medicaid Providers? Read More »
(July 23, 2014): Rightly or wrongly, critics of our nation’s long-term care system have long cited incidents of patient abuse, neglect, and the alleged misappropriation of funds among the identified widespread problems many seniors face when receiving long-term care and treatment services. In an effort to address these problems, legislators were sure to include provisions
OIG Report on the Nationwide Background Check Program Read More »
CMS’ Proposed Rule Would Update 2015 Home Health Prospective Payment System, Includes Important Updates and Additional Proposals
CMS’ Proposed Rule Updates 2015 Home Health PPS Rates Read More »