Health Law RX

NOVEMBER 9, 2021

For the first time since 2013, on November 8, 2021, the Department of Health and Human Services Office of Inspector General (“OIG”) updated its Health Care Fraud Self-Disclosure Protocol (“SDP”). The likelihood that a self-discloser would be required to pay a damages multiplier greater than 1.5

Fraud 52

Fraud Overpayment Overpayments Governance 52

Health Law Advisor

AUGUST 25, 2023

These regulations were proposed to implement portions of the New York State 2020-2021 Budget Bill amending the mandatory compliance program requirements. The regulations were finalized in December 2022, with an effective date of March 28, 2023, and an enforcement moratorium that has just ended. Lines of Communication.

Compliance 52

Compliance Overpayments Overpayment Compliance Officers 52

Innovaare Compliance

MARCH 24, 2024

The Importance of Payment Integrity Payment integrity is crucial for health plans to control costs, reduce fraud, waste, and abuse (FWA), and ensure the accuracy of healthcare payments. billion in healthcare fraud judgments and settlements. billion in healthcare fraud judgments and settlements.

Fraud 52

Fraud Compliance Health Insurance Medicaid 52

Innovaare Compliance

MARCH 24, 2024

The Importance of Payment Integrity Payment integrity is crucial for health plans to control costs, reduce fraud, waste, and abuse (FWA), and ensure the accuracy of healthcare payments. billion in healthcare fraud judgments and settlements. billion in healthcare fraud judgments and settlements.

Fraud 52

Fraud Health Insurance Medicaid Medicaid 52

Healthcare IT Today

FEBRUARY 2, 2023

It has given every indication that it intends to investigate fraud, waste, and abuse more robustly in the foreseeable future. The Justice Department has joined the fraud case against one large national insurer. In the most recent audit , the organization looked at more than 15,000 beneficiaries in the payment year 2021.

Medicare 64

Medicare Medicare Overpayment Overpayments 64

The Health Law Firm Blog

APRIL 21, 2023

Board Certified by The Florida Bar in Health Law On September 7, 2021, federal prosecutors announced the arrest of a Florida surgeon and owner of device company SpineFrontier Inc on charges of bribing surgeons to use products by paying sham consulting fees. By George F. Indest III, J.D., Accused in an indictment in [.]

Overpayment 40

Overpayment Overpayments Fraud Medicaid 40

The Health Law Firm Blog

JANUARY 24, 2022

Board Certified by The Florida Bar in Health Law On September 7, 2021, federal prosecutors announced the arrest of a Florida surgeon and owner of device company SpineFrontier Inc on charges of bribing surgeons to use products by paying sham consulting fees. By George F. Indest III, J.D., Accused in an indictment in.

Overpayment 40

Overpayment Overpayments Fraud Medicaid 40

Hall Render

DECEMBER 6, 2022

As part of the final regulations released by the Centers for Medicare & Medicaid Services (“CMS”) effective January 19, 2021, CMS finalized a new exception for arrangements where an entity pays a physician less than $5,000 over the course of a calendar year in exchange for items or services. New Exception for Limited Remuneration.

COVID-19 40

COVID-19 Hospitals Overpayment Overpayments 40

Healthcare IT Today

FEBRUARY 17, 2023

This article focuses on the relatively young technologies that enable CMS to uncover overbillings, whether they be errors or fraud. Challenges of Investigating Overpayments Undeserved payments are needles lurking in the haystack of 135 million Americans enrolled in Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP).

Overpayment 85

Overpayment Overpayments COVID-19 Medicare 85

Hall Render

APRIL 26, 2024

New California rule aims to limit health care cost increases to 3% annually UC San Diego Health operations deal with California hospital slows to crawl Kaiser reports data breach affecting 13.4M health dept. processed 1.5 MASSACHUSETTS High demand is pushing hospitals past their limits, say Southeastern Mass.

Nursing Homes 40

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

Hall Render

AUGUST 26, 2022

Alaska’s COVID ‘superstorm’ experience of 2021 offers lessons for future pandemics, study says. Charles workers launch petition, refuse to repay overpayments without outside audit; union files BOLI complaint. CHS faces class-action fraud suit. Health care giant to pay Washington $19M to resolve allegations of Medicaid fraud.

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Nursing Homes COVID-19 Nurses Hospitals 40