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OIG Releases New Industry-Specific Compliance Program Guidance for Nursing Facilities

Health Law Attorney

This guidance builds upon and updates the 2000 Compliance Program Guidance (CPG) and the 2008 Supplemental Compliance Program Guidance (Supplemental CPG) for Nursing Facilities, carrying forward key risk areas and considerations while addressing new and evolving compliance challenges.

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Texas Adult Day Care Owner Sentenced for Healthcare Fraud Scheme

Healthcare Compliance Blog

in restitution for her role in healthcare fraud, wire fraud, and theft of government funds. Court documents show that between 2008 and 2016 the former owner defrauded the Texas Medicaid program by billing for items and services that had not been provided to the clients of the day care centers. US Attorney Ashley C.

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DOJ Releases FY 2021 False Claims Act Recoveries: A Record-Shattering Year for Health Care and Life Sciences Enforcement, with Over $5 Billion Collected

Health Law Advisor

FY 2021 was also a record-shattering year for DOJ as it relates to health care fraud enforcement; over $5 billion (90% of the total) was obtained from cases pursued against individuals and entities in the health care and life sciences industries. With collections amounting to $5.6 billion received in FY 2020.

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Recent Developments in Telehealth Enforcement

Healthcare Law Blog

Now, almost three years later, governmental entities have focused their attention on telehealth services and the potential for fraud and abuse. In addition to the lack of information from the federal government regarding the permanency of the waivers, it is also unclear how states will approach the Ryan Haight Act after the PHE.

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OIG Removes Barrier to Requests for and Issuances of Advisory Opinions When the Same Conduct is Under Investigation

Health Care Law Brief

See e.g. , Advisory Opinion 21-10 as an example of the former, available at Advisory Opinion 21-10 | Office of Inspector General | Government Oversight | U.S. See , e.g. , Advisory Opinion 21-18, available at Advisory Opinion 21-18 | Office of Inspector General | Government Oversight | U.S. at 1368 (emphasis added).

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Why Data Analytics are Critical in a Value-Based Care (VBC) Environment

AIHC

As more and more potential and real fraud, waste, and abuse was uncovered in the FFS arena, it was also discovered that patient outcomes were less than stellar. Data Governance Metrics: These include metrics related to data cataloging, metadata management, and data stewardship practices.

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Why Data Analytics are Critical in a Value-Based Care (VBC) Environment

AIHC

As more and more potential and real fraud, waste, and abuse was uncovered in the FFS arena, it was also discovered that patient outcomes were less than stellar. Data Governance Metrics: These include metrics related to data cataloging, metadata management, and data stewardship practices.