Healthcare Law Today

JANUARY 2, 2023

” The currently proposed provision has similar effect to the language CMS proposed in 2012 and, after consideration of comments, ultimately rejected in the 2014 Final Rule (Medicare Advantage and Part D) and 2016 Final Rule (Medicare Part A and Part B). The FCA is a fraud statute, requiring intent. 3729(b)(1)(A).

Overpayment 52

Overpayment Overpayments ACA Medicare 52

Provider Trust

MARCH 16, 2022

Exclusions are administrative actions that are placed upon an individual or entity by HHS OIG, a state agency or Medicaid Fraud Control Unit (MFCU), or by one of the many agencies associated with SAM.gov. The SAM.gov database is formerly known as the Government Services Administration’s (GSA) list of Excluded Parties List System (EPLS).

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

Innovaare Compliance

FEBRUARY 9, 2021

The Affordable Care Act of 2010 mandates the CMS to make quality bonus payments (QBPs) to Medicare Advantage (MA) organizations that achieve at least four stars in a 5-star quality rating system and, starting in 2012, the CMS incentivizes health plans to improve member experiences by increasing the QBP amount, based on their star rating.

Medicare 40

Medicare Medicare Medicaid Medicaid 40

New Jersey Healthcare Blog

JULY 22, 2022

907(b), the Department of Human Services, Division of Mental Health and Addiction Services readopted rules that govern the provision of mental health services at inpatient psychiatric hospital units known as short-term care facilities (STCFs). In 2012, N.J.S.A. See proposed new rules N.J.A.C. On May 16, 2022, at 54 N.J.R. See N.J.A.C.

COVID-19 Vaccine 40

COVID-19 Vaccine Licensing COVID-19 Public Health 40

Kaiser Health News

APRIL 8, 2022

What happened in the two years between the contract award and the start of the program is a case study in what can go wrong when government outsources core functions to the private sector. California awarded the Medi-Cal Rx program to a unit of Magellan Health, a company with expertise in pharmacy benefits and mental health.

Medicaid 103

Medicaid Medicaid Health Insurance COVID-19 103

Drug & Device Law

JANUARY 30, 2023

470 (1996), was decided – removing express preemption as a defense for manufacturers of §510(k) products So defendants moved on fraud on the FDA under an implied preemption theory and won. Mensing , 564 U.S. Mensing , 564 U.S. Lohr , 518 U.S. Davidowitz , 312 U.S. Davidowitz , 312 U.S.

FDA 72

FDA Fraud Governance Medicare 72

Drug & Device Law

AUGUST 8, 2022

The unfortunate truth is that ECFMG was also a victim of this fake doctor’s fraud. Furthermore, trade associations often serve to assist the government in areas that it does not regulate. 2012 WL 3265002, at *5 (N.D. Typically overblown MDL claims for “fraud” and “conspiracy” also failed. at 183 (quoting Meyers v.

Doctors 52

Doctors Fraud Licensing Compliance 52