The Health Law Firm

SEPTEMBER 25, 2018

Board Certified by The Florida Bar in Health Law On August 22, 2018, a doctor received a sentence of one year and a day in prison from a New York federal court for his part in a $30 million scheme to defraud Medicare and the state Medicaid program. Indest III, J.D., Lies and Cover-ups.

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The Health Law Firm

JANUARY 4, 2019

Board Certified by The Florida Bar in Health Law On December 3, 2018, a Florida judge ruled that a Miami businessman who has been jailed for more than two years on $1 billion health care fraud charges, must remain in custody through his trial next year. By George F. Indest III, J.D., US District Judge Robert N.

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HIPAA Journal

JANUARY 23, 2024

Theranos and Homes denied the allegations and threatened to sue Carreyrou; however, in 2018, Homes stepped down from her position as CEO, and following an FBI investigation the company was shut down. HHS-OIG Issues Notice of Exclusion HHS-OIG Inspector General Christi A.

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HIT Consultant

NOVEMBER 24, 2022

– Delivery model : Whether to ship OTC products to a hearing clinic where the consumer can receive professional diagnosis, fitting and support, or ship directly to the consumer’s home thereby providing convenience but no professional support (and increased fraud risk), or offer both options? – Fraud. million U.S.

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HIPAA Journal

MARCH 20, 2025

2023, OCR reported a 239% increase in hacking-related data breaches between January 1, 2018, and September 30, 2023, and a 278% increase in ransomware attacks over the same period. PA Business Associate 2,675,934 Hacking/IT Incident 45 2018 AccuDoc Solutions, Inc. In 2019, hacking accounted for 49% of all reported breaches.

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Health Care Law Brief

APRIL 12, 2023

On April 5, the Centers for Medicare & Medicaid Services (“CMS”) released the 2024 Medicare Advantage and Prescription Drug Benefit Programs Final Rule (“Final Rule”), which will be codified at 42 C.F.R. 405.986) or “reliable evidence” of fraud or “similar fault” (as defined in 42 C.F.R. Parts 417, 422, 423, 455, and 460.

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Healthcare IT Today

AUGUST 14, 2024

It ensures timely patient access to care, automatic claim processing, network management, compliance, fraud detection, physician recruitment and more. The Centers for Medicare and Medicaid Services reported more than 45% of provider office locations listed in online directories contained at least one error.

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Pharmacy Law Blog

MARCH 13, 2018

She accused RS and Gobea of charging Tricare, Medicare and Medicaid excessively high rates for certain compounded drugs. fraud suit – judge.” Copyright © 2018 The Health Law Firm. The Relator’s FCA Suit. The relator McKenzie Stepe, a former RS sales representative, originally filed her complaint in December 2013.

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CMS.gov

NOVEMBER 16, 2018

2018 Medicare Fee-For-Service improper payment rate is lowest since 2010. Fri, 11/16/2018 - 18:46. Administrator, Centers for Medicare & Medicaid Services. Fraud, waste, & abuse. Most notably: The 2018 Medicare-FFS improper payment rate decreased from 9.51 percent in 2018. percent in 2018.

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AIHC

APRIL 5, 2022

Due to the huge volume of claims payers receive to process, deny and pay, they have implemented various methods to track providers to detect potential waste, fraud and/or abuse. If the payer, such as Medicare, performs an extrapolation, reducing each overpayment dollar through appeal can mean thousands less to pay back.

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HIPAA Journal

JULY 24, 2023

The team’s roles are to investigate and audit the Department’s operations to prevent fraud, waste, and abuse within the Department, and also to audit and investigate potential crimes against the Department. Subsequent Acts of Congress increased the OIG’s regulatory authority to prevent crimes against the Department.

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Health Populi

JUNE 4, 2019

” In 2018, 45% of Americans between 19 and 64 years of age were under-insured, facing relatively flat wage growth coupled with triple-digit health care cost increases over more than a decade. The rationale for the project is that, “America’s families are hurting from high-cost, low-quality care.”

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McGuire Wood

OCTOBER 2, 2023

According to the DOJ press release, from January 2013 to July 2018, Oliver Street, doing business as U.S. The disclosure noted that claims for certain referred services were submitted for payment to Medicare, thus invoking the reach of the implicated federal laws. Care in email and transactional slides is warranted.

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Florida Health Care Law Firm

FEBRUARY 22, 2022

In yet another take-down of an illicit scheme to defraud the Medicare Program and ChampVA, as well as other insurers, Patsy Truglia has been sentenced to 15 years in federal prison. He has also had assets forfeited since these assets were acquired with money from his ill-gotten fraud scheme. million being paid to Truglia and company.

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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. Medicare Advantage and Part D) for a comprehensive assessment of a health plan’s performance. Read More – Medicare Star Ratings Changes 2021 . Industry trends.

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CMS.gov

JUNE 20, 2018

Wed, 06/20/2018 - 16:17. Fraud, waste, & abuse. Over the past year, the Centers for Medicare & Medicaid Services (CMS) has engaged with the provider community in a discussion about regulatory burden issues. Medicare’s regulations must support this close collaboration. Working Together for Value. lisa.sokol@cms….

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Provider Trust

MAY 18, 2022

Additionally, check out this HHS-OIG 2016 report, Medicare: Vulnerabilities Related to Provider Enrollment and Ownership Disclosure , which revealed “vulnerabilities that could allow potentially fraudulent providers to enroll in the Medicare program.”. The Massachusetts Attorney General had already fined South Bay $4M in February 2018.

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CMS.gov

OCTOBER 2, 2018

Tue, 10/02/2018 - 15:36. Administrator, Centers for Medicare & Medicaid Services. It also enhances the ability to identify potential fraud and improve program efficiency. Better Data Will Serve as the Foundation in Modernizing the Medicaid Program. Jeremy.Booth@c…. Seema Verma. Medicaid & CHIP.

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Hall Render

JULY 12, 2023

If a deemed hospice fails to meet the Medicare requirements or shows continued condition-level noncompliance, deemed status is generally removed and oversight is placed under the SA. Selected hospices either successfully complete the SFP program or are terminated from the Medicare program. of hospice providers reported data.

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Pharmacy Law Blog

MARCH 8, 2018

They face maximum sentences of 10 years in prison on the health care fraud counts. Copyright © 2018 The Health Law Firm. If convicted, each defendant faces a maximum sentence of 20 years in prison on the drug conspiracy and distribution counts. To read the indictment in full, click here. According to the U.S. Indest III, P.A.

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Florida Health Care Law Firm

DECEMBER 9, 2021

The Rule does not apply to people with coverage through Medicare, Medicaid, Indian Health Services, Veteran Affairs Health Care or TRICARE as these programs already contain protections against high medical bills. Bans balance billing for emergency services.

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Hall Render

NOVEMBER 28, 2023

On November 1, 2023, the Centers for Medicare & Medicaid Services (“CMS”) posted a pre-publication copy of the Calendar Year (“CY”) 2024 Home Health Prospective Payment System Rate Update Final Rule (“2024 Final Rule”), which has since been filed in the Federal Register. 7,872 2018 5,851 77.1% 7,589 2019 5,871 79.3% Deactivation.

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Health Law Advisor

MARCH 7, 2023

In 2018, Congress passed requirements under the Substance Use-Disorder Prevention That Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act, requiring DEA to create a special registration for opioid addiction treatment via telehealth by October 2019. Impact on Pharmacies.

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Telemedicine COVID-19 FDA Compliance 52

Med Law Blog

MAY 1, 2023

Tenet went through its own bankruptcy difficulties and, in 2018, sold its remaining Philadelphia assets, i.e. Hahnemann Hospital and St. Howell, Constantine Yannelis and Abhinav Gupta positing that their research shows that “PE ownership increases short term mortality of Medicare patients by 10%, in nursing homes”.

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Nursing Homes Malpractice Hospitals Nurses 52

AIHC

FEBRUARY 16, 2024

To begin, the authors use Medicare patients who are diagnosed with aspiration pneumonia: “This study, one of the largest undertaken of aspiration pneumonia, confirms that patients with aspiration pneumonia are older, have more comorbidities, and are more likely to die than with other forms of pneumonia.

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Compliance US Department of Health and Human Services COVID-19 Hospitals 52

AIHC

FEBRUARY 16, 2024

To begin, the authors use Medicare patients who are diagnosed with aspiration pneumonia: “This study, one of the largest undertaken of aspiration pneumonia, confirms that patients with aspiration pneumonia are older, have more comorbidities, and are more likely to die than with other forms of pneumonia.

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Compliance US Department of Health and Human Services COVID-19 Hospitals 52

CMS.gov

NOVEMBER 2, 2018

CMS BLOG: Medicare for All? Fri, 11/02/2018 - 21:32. Seema Verma, Administrator, Centers for Medicare & Medicaid Services . Medicare Part C. Medicare Part D. November 2, 2018. Medicare for All? When listening to those advocating ‘Medicare for All’ it’s good to be skeptical about their promises.

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CMS.gov

DECEMBER 21, 2018

Fri, 12/21/2018 - 13:09. Administrator, Centers for Medicare & Medicaid Services. Medicare Parts A & B. Pathways to Success,” an Overhaul of Medicare’s ACO Program. Today the Trump Administration announced our overhaul of the program for Accountable Care Organizations, or “ACOs,” in Medicare. Jeremy.Booth@c….

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Medicare Medicare Payment Systems Fraud 41

New Jersey Healthcare Blog

JULY 22, 2022

1117(a), the Department of Human Services, Office of Program Integrity and Accountability proposed amendments, repeals, and new rules to comply with the Department’s Fee-for-Service initiative, the Centers for Medicare and Medicaid Services’ guidelines for funding, Danielle’s Law, P.L. On June 20, 2022, at 54 N.J.R.

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COVID-19 Vaccine Licensing COVID-19 Public Health 40

Hall Render

JULY 14, 2023

Vernon receives award to improve stroke care Health system to expand Illinois hospital after $23.5M renovation Reid Health details restructuring effort to reduce costs Cameron Hospital, Trine break ground on $10M nursing education center IOWA 26 Nursing Homes Close in the Past Year Across Iowa Groundbreaking set for new UnityPoint – St.

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US Department of Health and Human Services Nursing Homes Nurses Hospitals 40

Hall Render

MARCH 17, 2023

‘Not what we were looking for,’ CEO says Fired CEO files slander, defamation suit against Scotland County Hospital Missouri health system appoints strategy chief Missouri physician pleads guilty to $537K Medicare fraud scheme New Behavioral Health Crisis Center Open in Cape Girardeau St. Who are they? Roy Cooper’s $32.9

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US Department of Health and Human Services COVID-19 Nursing Homes Nurses 40

Hall Render

JUNE 9, 2023

NATIONAL As AI advances in healthcare, industry players wrestle with its risks AHA Comments on FY 2024 Proposed Rule for Skilled Nursing Facilities AHA rebukes ‘flawed’ study on hospital finances AHA urges CMS to consider inflation, staffing in light of proposed inpatient rehab rule AHCA prepared to sue over minimum staffing mandate AMA, (..)

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Hall Render

APRIL 28, 2023

renovation Police: Man facing arson charges after setting 3 fires inside Florida hospital St. million to benefit South Side and south suburban communities in fiscal 2022 INDIANA Beacon Health announces hiring freeze, pay cuts for employees Carmel-based NICO Corp.

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Hall Render

FEBRUARY 7, 2025

fraud scheme Banner names Seattle physician-scientist to C-suite role Bill would require Arizona hospitals to ask about immigration status Phoenix Children’s receives $2.25 Alaska Mental Health Trust Authority chooses new chief executive ARIZONA Arizona couple pleads guilty to $1.2B The university says no. area clinics, eyes more D.C.

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