The Health Law Firm

MAY 4, 2012

Over 100 doctors, nurses and other health professionals were arrested on charges relating to Medicare fraud by federal agents on May 2, 2012. Indest III, J.D., Board Certified by The Florida Bar in Health Law. The arrests were made in seven cities nationwide, but more than half took place in South Florida.

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Fraud Medicare Medicare Medicaid 40

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. Additionally, there are varying, disparate State Medicaid exclusions sources that require periodic screening.

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Medicaid Medicaid Medicare Medicare 52

The Health Law Firm

OCTOBER 3, 2012

On September 19, 2012, power wheelchair suppliers voiced their concerns over a new government program called the Power Mobility Devices (PMDs) Demonstration at a Senate Special Committee on Aging. To see the Power Mobility Devices (PMDs) Demonstration operational guide from the Centers for Medicare and Medicaid Services (CMS), click here.

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Medicare Medicare Fraud Medicaid 40

The Health Law Firm

JULY 12, 2012

The nurse was arrested on a felony warrant by the Attorney General’s Medicaid Fraud Control Unit (MFCU). The arrest was announced by the Florida Attorney General on June 29, 2012. Abuse Allegedly Occurred During Medication Administration.

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Nurses Fraud Licensing Medicaid 40

The Health Law Firm

SEPTEMBER 19, 2012

A former employee of an organization that provides services to developmentally disabled adults in Alachua County, Florida, was arrested on June 15, 2012, according to the Attorney General’s (AG) Office. Investigation by the Medicaid Fraud Control Unit (MFCU) Led to Arrest. To see the press release from the AG, click here.

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Fraud Medicaid Medicaid 40

The Health Law Firm

MARCH 4, 2013

A report released by the Government Accountability Office (GAO) on February 27, 2013, announced that Medicare will remain a "high-risk" program with respect to its fraud and waste vulnerability. In 2012, according to the report, CMS let more than $44 billion in improper payments go out. Click here to view the full report from the GAO.

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Medicare Medicare Fraud Medicaid 40

HIPAA Journal

OCTOBER 21, 2022

For example, the Administrative Requirements (Part 162) helped reduce insurance fraud and accelerated eligibility inquiries, authorization requests, and claims processing. Only one penalty was issued in each of 2008 and 2009, 2 in 2010, 3 in 2011, and 6 in 2012. billion and $11.5

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HIPAA Compliance Medicare Medicare 106

HIPAA Journal

MARCH 20, 2025

150,000 Settlement 2012 Alaska DHSS $1,700,000 Settlement 2012 Massachusetts Eye and Ear Infirmary and Massachusetts Eye and Ear Associates, Inc. Dominion National Insurance Company, and Dominion Dental Services USA, Inc. CA Healthcare Provider 2,364,359 Hacking/IT Incident 57 2024 Medical Management Resource Group, L.L.C.

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HIPAA Ransomware Compliance Hospitals 109

Hall Render

JANUARY 29, 2025

The enforcement of the False Claims Act in this case demonstrates the governments desire to disrupt health care fraud and abuse. The United States Department of Justice (DOJ) recently settled part of a qui tam lawsuit under the False Claims Act for alleged violations of the Medicare 14-Day Rule for $388,667.

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Medicare Medicare Hospitals Compliance 52

Innovaare Compliance

FEBRUARY 9, 2021

Annually, the Centers for Medicare & Medicaid Services (CMS) releases star ratings, which measure the quality of care health plans deliver for its members. Inovaare’s A&G software optimizes your processes so you can handle large volumes of data, reduce costs and ensure transparency to prevent fraud at every step. References.

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Medicare Medicare Medicaid Medicaid 40

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).

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Overpayments Overpayment ACA Medicare 52

Kaiser Health News

APRIL 8, 2022

Prescription drug costs for California’s massive Medicaid program were draining the state budget, so in 2019 Gov. The new Medicaid drug program debuted this January, with a private company in charge. Centene was already a big player in state Medicaid drug programs — but one with a questionable record. SACRAMENTO, Calif.

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Medicaid Medicaid Health Insurance COVID-19 103

Health Populi

OCTOBER 8, 2019

The study reviewed reports and articles published between January 1, 2012 and May 15, 2019, dressing the topic of waste across six domains previously identified by the Institute of Medicine: Failure of care delivery, with waste ranging between $102 bn and $166 bn. Failure of care coordination, with a waste-range of $27 bn – $78 bn.

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Prescription Drug Pricing Medicare Medicare ACA 108

New Jersey Healthcare Blog

JULY 22, 2022

The chapter describes the policies and procedures of the New Jersey Medicaid/NJ FamilyCare program regarding transportation services. In 2012, N.J.S.A. On April 4, 2022, at 54 N.J.R. 620(b), the Department of Human Services, Division of Medical Assistance and Health Services adopted amendments to Transportation Services Rules.

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COVID-19 Vaccine Licensing COVID-19 Public Health 40