Health Law Attorney

APRIL 22, 2021

The Act extends the temporary suspension of certain mandatory Medicare FFS claim payment reductions until December 31, 2021. President Obama issued a Sequestration Order in March 2013. Amongst other things, the CARES Act temporarily suspended sequestration of Medicare FFS claims from May 1, 2020 through December 31, 2020.

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The Health Law Firm

FEBRUARY 1, 2016

Board Certified by The Florida Bar in Health Law On Friday, a Miami pharmacy owner charged in a Medicare fraud scheme, surrendered to US authorities after hiding in Cuba for over two years. Sandy De La Fe, was charged in 2013 with unlawfully pocketing $2.8 Indest III, J.D., False Claims for Prescription Drugs.

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Healthcare IT News - Telehealth

OCTOBER 19, 2020

In the suit, the EHR giant argues that it has used the CarePort trademark since 2013 and that in 2018 the telemedicine company changed its name from ER at Home to CarePortMD. Earlier this summer, CarePort launched a tool to help hospitals comply with the Centers for Medicare and Medicaid Services' interoperability final rules.

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Telemedicine Medicaid Medicaid Hospitals 135

HIT Consultant

OCTOBER 27, 2023

in 2013 to 4.6% Data from MSSP, Medicare’s largest ACO program serving 11 million beneficiaries, consistently indicates that primary care-focused ACOs (more than 75% of clinicians are primary care) provide higher-value services on a population basis, producing more than twice the savings as hospital-based ACOs.

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COVID-19 Medicare Medicare Hospitals 98

Healthcare IT Today

APRIL 28, 2023

billion through Arcadia’s Medicare Shared Savings Program (MSSP) service. Since formation in 2013 and as of December 31, 2022, VCP has deployed over $9.7 The past year included several important milestones for Arcadia, including: Inclusion on Inc. billion and grown to over $6.6 billion of assets under management.

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Medicare Medicare Health Outcomes Hospitals 119

The Health Law Firm

AUGUST 29, 2013

Board Certified by The Florida Bar in Health Law A therapy staffing company owner and a patient recruiter pleaded guilty on August 21, 2013, to one count each of conspiracy to commit health care fraud in connection with a $7 million Medicare fraud scheme. Indest III, J.D., Click here to read the press release from the DOJ.

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The Health Law Firm

JANUARY 28, 2013

A family that owns a number of South Florida pharmacies is allegedly under investigation for Medicare fraud, according to a number of sources. On January 17, 2013, federal authorities raided one pharmacy location in Naples, Florida. Indest III, J.D., Board Certified by The Florida Bar in Health Law.

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US Department of Health and Human Services Medicare Medicare Fraud 40

The Health Law Firm

OCTOBER 9, 2013

Board Certified by The Florida Bar in Health Law The University of Miami Hospital allegedly owes Medicare $3.7 The report was released on October 8, 2013, by the US Department of Health and Human Services (HHS) Office of Inspector General (OIG). Indest III, J.D.,

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US Department of Health and Human Services Medicare Medicare Overpayments 40

Hall Render

JUNE 8, 2023

On June 7, CMS issued a much-anticipated Final Rule addressing the placement of Medicare Advantage patient days within the Medicare DSH calculation. The Final Rule adopts a retroactive policy that will place Medicare Advantage days in the Medicare Fraction of the DSH calculation for discharges before October 1, 2013.

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Medicare Medicare Hospitals Governance 40

The Health Law Firm

SEPTEMBER 3, 2013

million to settle claims it overbilled Medicare and Medicaid for cancer clinical trial services that were not permitted by the Medicare and Medicaid rules. This announcement from the Department of Justice (DOJ) was released on August 28, 2013. Indest III, J.D.,

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The Health Law Firm

SEPTEMBER 24, 2013

Leider with The Health Law Firm will be giving a presentation on Thursday, September 26, 2013, to the members of the Medical Office Resources of Florida (MOROF) and attending health care providers. This presentation is called, “Medicare and Medicaid Audits: Ready or Not, Here They Come.” Brown and Lance O.

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The Health Law Firm

JANUARY 28, 2014

By George F. Indest III, J.D.,

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US Department of Health and Human Services Medicare Medicare Nursing Homes 40

Hall Render

NOVEMBER 17, 2023

The Centers for Medicare and Medicaid Services (“CMS”) Medicare Advantage final rule for 2024 (“Final Rule”) clarified that Medicare Advantage plans must adhere to the “two-midnight rule” when making coverage determinations for inpatient services. 1395w-22(a) ). d)(2) ).

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Healthcare IT Today

FEBRUARY 27, 2024

HealthBeacon was founded in 2013 in Dublin, Ireland. The product is patent protected, FDA cleared, and FSA, HSA, Medicare, and Medicaid eligible. Postal Service’s approved mail-back program. HealthBeacon also provides a digital risk management platform for prescribing restricted medication to oncology patients.

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Healthcare IT News - Telehealth

JULY 18, 2022

"Since 2013, we had provided e-consults as one of the original AAMC Project CORE institutions," she added. "In 2019, UVA Health created a multi-stakeholder strategic plan for telemedicine.

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COVID-19 Telemedicine Electronic Medical Records Hospitals 173

Electronic Health Reporter

JULY 23, 2018

The successor to the 2013 BPCI program, BPCI Advanced is CMS’ most significant episodic payment reform proposal to date, indicating the government’s […]. The Bundled Payments for Care Improvement (BPCI) Advanced initiative is a new advanced alternative payment model (APM) that will go live October 1, 2018.

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Medicare Medicare 79

The Health Law Firm

JULY 26, 2013

Board Certified by The Florida Bar in Health Law On July 23, 2013, the House Energy and Commerce Health Subcommittee approved a proposal to repeal Medicare’s sustainable growth rate (SGR) physician payment formula in lieu of a system that rewards doctors for high quality care. Leider, J.D., The Health Law Firm and George F.

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Medicare Medicare Doctors 40

The Health Law Firm

MAY 10, 2013

A Miami patient recruiter will spend the next 37 months in prison for his part in a $20 million Medicare fraud scheme, according to the Department of Justice (DOJ). Manuel Lozano was sentenced on May 6, 2013, in the Southern District of Florida. Indest III, J.D., Board Certified by The Florida Bar in Health Law.

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AIHC

JANUARY 28, 2022

For more information on filing compliance cost reports, attend the Medicare Cost Report Camp in March 2022 presented by KraftCPAs and sponsored by the American Institute of Healthcare Compliance. This is calculated based on the hospital’s relative share of uncompensated care nationally. This is known as the hospital “market basket.”

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Med-Net Compliance

SEPTEMBER 9, 2022

to resolve allegations that they submitted false claims to Medicare and Medicaid. The ophthalmologist was identified by HHS-OIG as one of the top outliers for billing the Medicare program across all medical specialists in West Virginia, far exceeding the average of Medicare claims submitted by his peers.

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Medicare Medicare Medicaid Medicaid 59

Healthcare Compliance Blog

MAY 19, 2022

million to settle allegations that it violated the False Claims Act by submitting false claims to Medicare. The voluntary disclosure and investigation revealed that from June 1, 2013, through May 31, 2019, the hospital submitted claims to Medicare for Intensive Cardiac Rehabilitation (ICR) services provided to Medicare beneficiaries.?Before

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US Department of Health and Human Services Hospitals Medicare Medicare 59

HIT Consultant

FEBRUARY 16, 2023

In 2013, My mother would have met the screening criteria to get a CT but she did not get scanned and in September of that year, her stage 4 lung cancer was identified and she died shortly after. This is an issue that primary care is struggling with, compounded by the lack of time to properly see and assess patients during the day.

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Doctors Medicare Medicare Compliance 98

HIT Consultant

FEBRUARY 16, 2023

In 2013, My mother would have met the screening criteria to get a CT but she did not get scanned and in September of that year, her stage 4 lung cancer was identified and she died shortly after. This is an issue that primary care is struggling with, compounded by the lack of time to properly see and assess patients during the day.

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Doctors Medicare Medicare Compliance 98

Healthcare Compliance Blog

MAY 9, 2022

million to the United States government to settle claims of improperly billing the Medicare Program for home health services provided to beneficiaries living in Florida. Juan Antonio Gonzalez, US Attorney for the Southern District of Florida, stated, “The fraudulent billing of Medicare will not be tolerated.

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US Department of Health and Human Services Medicare Medicare Compliance 59

HIPAA Journal

OCTOBER 21, 2022

In 2013, HHS confirmed that paper-to-paper, non-digital faxes are not covered transactions). Advocates of NPIs are hoping that the introduction of Medicare Beneficiary Numbers (which went into effect in January 2020) will demonstrate to Congress that the benefits of NPIs far outweigh the costs. #4.

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HIPAA Compliance Medicare Medicare 107

Healthcare Compliance Blog

JANUARY 14, 2022

million to settle allegations that the company sold custom fabricated shoe inserts to Medicare recipients that did not meet Medicare standards. Custom shoe inserts for diabetic patients can be covered by Medicare and Medicaid. A Florida based diabetic shoe company has agreed to pay over $5.5

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Medicare Medicare Medicaid Medicaid 59

HIT Consultant

AUGUST 17, 2023

Needs more training for healthcare workers to manage the technology and remote consultations The Department of Health and Human Services has made permanent changes to Medicare telehealth policies influenced by the pandemic. That goes for maternity care, too. Since the company’s inception, they have raised over $37M.

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Medicaid Medicaid Telemedicine Doctors 98

HIPAA Journal

JUNE 9, 2023

In 2013, David Dubin was examining a patient when he was informed by his father that the patient’s Medicaid benefits had been exhausted and cut the evaluation short. The Supreme Court decision related to the latter. William and David Dubin are father and son psychologists who ran a mental health testing company called Psychological ARTs.

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Fraud Medicaid Medicaid Doctors 107

Health Populi

JUNE 23, 2022

points which was the biggest two-week decline in the past year — and the lowest level since CivicScience launched this study in 2013. billion savings that Medicare Part D could accrue if the program bought generic drugs at the prices offered through the Mark Cuban Cost Plus Drug Company. Yes, that Mark Cuban).

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Medical Billing Medicare Medicare Hospitals 115

The Health Law Firm

MARCH 21, 2016

in December 2013. Indest III, J.D., Board Certified by The Florida Bar in Health On February 3, 2016, the US District Court for the Eastern District of Michigan denied a motion to suppress all evidence of health care fraud seized by the government pursuant to a search warrant of Naseem Minhas’s home health care agency.

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Fraud Medicare Medicare Governance 40

HIPAA Journal

FEBRUARY 23, 2022

The preamble could give the impression that the Administrative Simplification provisions of HIPAA Title II will improve accessibility to and affordability of the Medicare and Medicaid programs, or that the development of a health information system would streamline the provision of healthcare between providers.

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HIPAA Fraud Health Insurance Medicaid 99

The Health Law Firm

AUGUST 16, 2013

According to the Daytona Beach News-Journal, the surgeon allegedly made an initial incision into a patient’s right leg when it was suppose to be made in the left leg on July 3, 2013.

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Hospitals Medicaid Medicaid Medicare 40

The Health Law Firm

JANUARY 2, 2014

Board Certified by The Florida Bar in Health Law On December 12, 2013, the US House of Representatives passed a three-month patch to stabilize physicians’ Medicare payments, delaying a nearly twenty-four percent (24%) cut in Medicare payments that was scheduled for physicians in 2014. Indest III, J.D.,

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Medicare Medicare 40

The Health Law Firm

MARCH 6, 2014

Board Certified by The Florida Bar in Health Law The Centers for Medicare and Medicaid Services (CMS) continues to stop fraudulent repayment claims before they happen. The agency performed a similar enrollment moratorium in July 2013. Indest III, J.D., Click here to read the press release from CMS.

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Innovaare Compliance

MARCH 4, 2024

Until the enactment of the Medicare Modernization Act (MMA) in 2006 [1] , the Centers for Medicare & Medicaid Services does not cover most outpatient prescription drugs under Part B (“Part B drugs”). However, some drugs self-administered by Medicare beneficiaries at home are Part B eligible.

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Medicare Medicare Nurses Medicaid 52

American Medical Compliance

JANUARY 9, 2024

When someone uses your personal information, such as your name, Social Security number, or Medicare number, to make false claims to Medicare and other health insurers without your consent, it is known as medical identity theft. This wastes taxpayer money and interferes with your medical care. trillion in 2015.

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Fraud Medicare Medicare Compliance 52

The Health Law Firm

AUGUST 30, 2013

Board Certified by The Florida Bar in Health Law On August 2, 2013, the Centers for Medicare and Medicaid Services (CMS) released the 2014 Inpatient Prospective Payment System (IPPS) Final Rule (the 2014 IPPS Final Rule). By Lance O. Leider, J.D., The Health Law Firm and George F. Indest III, J.D.,

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Hospitals Payment Systems Medicaid Medicaid 40