Med-Net Compliance

JUNE 22, 2022

A registered nurse from a veteran’s hospital in Detroit pleaded guilty to charges related to COVID-19 vaccination record cards fraud. Issue: Legitimate vaccination cards are being stolen from healthcare facilities and then used in a fraudulent manner. Participating in the fraud can result in the person(s) being prosecuted.

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COVID-19 Vaccine COVID-19 Fraud US Department of Health and Human Services 59

The Health Law Firm

AUGUST 8, 2012

Board Certified by The Florida Bar in Health Law. The owner and operator of a Miami home health care agency pleaded guilty for his part in a $42 million home health Medicare fraud scheme, according to the Department of Justice (DOJ), the FBI and the Department of Health and Human Services (DHHS).

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US Department of Health and Human Services Fraud Medicare Medicare 40

HIPAA Journal

JANUARY 30, 2023

Attendees will gain valuable insights into health information privacy, healthcare cybersecurity, HIPAA enforcement, and a wealth of information to help them maintain HIPAA compliance and take healthcare data privacy and security to the next level. Jillson, JD – Counsel to the Director, Bureau of Consumer Protection, U.S.

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US Department of Health and Human Services HIPAA Compliance Medicaid 82

The Health Law Firm

JANUARY 2, 2013

The Office of Inspector General (OIG) of the US Department of Health and Human Services (HHS) is investigating a Tennessee-based nursing care company. By Danielle M. Murray, J.D. Click here to read the entire article from the Wall Street Journal.

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Provider Trust

JANUARY 26, 2022

It’s no secret–when fraud enters healthcare, things get risky. But how exactly does the HHS-OIG (Office of Inspector General), the main body responsible for conducting investigations into suspected fraudulent activity, address healthcare fraud and assess future risk of these bad actors? Department of Justice (DOJ), the U.S.

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YouCompli

AUGUST 22, 2023

Approximately 65 million Americans are enrolled in Medicare – about 34 million in traditional Medicare and the rest in Medicare Advantage. Traditional Medicare is administered by the federal government, and individuals pay a separate monthly premium for hospital visits, doctors/outpatient, and prescription drugs.

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Medicare Medicare US Department of Health and Human Services Compliance 52

Healthcare Compliance Blog

APRIL 26, 2022

The Office of Inspector General (OIG) for the US Department of Health and Human Services (HHS) has made educational resources available for healthcare providers to comply with federal healthcare laws and regulations. Voluntary Compliance: OIG has several self-disclosure processes to report fraud in HHS programs.

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US Department of Health and Human Services Fraud Compliance Medicaid 59

The Health Law Firm

OCTOBER 7, 2022

Board Certified by The Florida Bar in Health Law The US Department of Health and Human Services (HHS) issues investigative subpoenas through the Office of the Inspector General (OIG). Indest III, J.D., These subpoenas are very broad, usually requiring the production of thousands of pages of documents.

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US Department of Health and Human Services Fraud Medicaid Medicaid 52

American Medical Compliance

AUGUST 1, 2022

In Spring 2022’s Semiannual Report to Congress (SAR), the Department of Health and Human Services’ Office of Inspector General (HHS-OIG) reported that nearly $3 billion had been misspent on Medicare and Medicaid services. HHS Examines Medicare Spending and COVID-19 Tests.

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The Health Law Firm

AUGUST 18, 2015

Board Certified by The Florida Bar in Health Law On July 14, 2015, Ann Maxwell, Assistant Inspector General for Evaluation and Inspections of the Office of Inspector General (OIG), US Department of Health and Human Services (HHS), gave testimony to Congress on the Medicare Part D Program.

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US Department of Health and Human Services Medicare Medicare Fraud 40

The Health Law Firm

JANUARY 28, 2013

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

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US Department of Health and Human Services Medicare Medicare Fraud 40

American Medical Compliance

AUGUST 1, 2022

In Spring 2022’s Semiannual Report to Congress (SAR), the Department of Health and Human Services’ Office of Inspector General (HHS-OIG) reported that nearly $3 billion had been misspent on Medicare and Medicaid services. HHS Examines Medicare Spending and COVID-19 Tests.

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US Department of Health and Human Services COVID-19 Nursing Homes Medicare 52

Healthcare Compliance Blog

JUNE 9, 2022

His exclusion means that no federal healthcare program payment may be made, either directly or indirectly, for any items or services furnished by him or at his direction or prescription. Between 2017 and 2019, the man, through a group of pain clinics he controlled, caused the submission of false claims for payment to Medicare.

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US Department of Health and Human Services Overpayments Overpayment Medicare 59

The Health Law Firm

NOVEMBER 9, 2012

Board Certified by The Florida Bar in Health Law. The Office of Inspector General (OIG) for the US Department of Health and Human Services (HHS) has reportedly launched an investigation into CVS’ practice for refilling prescriptions. By George F. Indest III, J.D.,

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US Department of Health and Human Services Fraud Medicare Medicare 40

Healthcare Compliance Blog

MAY 10, 2022

According to a Medicaid Fraud Control Unit investigation, the provider had failed to disclose his former felony convictions that precluded Medicaid from accepting the application. The provider had created a business to provide home and community-based services to Medicaid recipients. List of Excluded Individuals/Entities ?(LEIE).

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Medicaid Medicaid US Department of Health and Human Services Fraud 59

Healthcare Compliance Blog

MAY 19, 2022

million to settle allegations that it violated the False Claims Act by submitting false claims to Medicare. Following an internal review and audit, the hospital discovered irregularities regarding its billing of certain services, and proactively contacted the United States to self-disclose the issues.?The to resolve the claims.

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HIT Consultant

NOVEMBER 13, 2023

hours entering electronic health records (EHR data), and managing patient loads of 2,000 or more. These healthcare organizations (HCOs) will deploy task-oriented and domain-specific models that build on large-language models (LLMs), using reinforcement learning and knowledge graphs to deliver relevant, accurate, and stable data outputs.

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Healthcare Law Blog

MARCH 17, 2022

On Thursday, March 16, the Office of the Inspector General for the Department of Health and Human Services (“OIG”) issued OIG Advisory Opinion (“AO”) No. 22-05 , relating to subsidization of certain Medicare cost-sharing obligations in the context of a clinical trial involving medical devices (the “Proposed Arrangement”).

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YouCompli

DECEMBER 7, 2022

Do your hiring managers and Human Resources colleagues know what to look for? Department of Health and Human Services Office of Inspector General (OIG) has the authority to exclude individuals and entities from federally funded healthcare programs. Provision of unnecessary or substandard services.

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Fraud US Department of Health and Human Services Compliance Medicaid 52

Compliancy Group

FEBRUARY 28, 2024

Within the US Department of Health and Human Services (HHS), the Centers for Medicare & Medicaid Services (CMS) is responsible for overseeing and administering various healthcare programs, including Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP).

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Compliance US Department of Health and Human Services Fraud Medicare 52

YouCompli

SEPTEMBER 13, 2023

Mitigating fraud, waste, and abuse (FWA) is taking on a new urgency for healthcare compliance professionals. Enforcement agencies are prioritizing efforts to deter FWA as more individuals enroll in government healthcare programs like Medicare and Medicaid, and telehealth services continue to evolve post-pandemic.

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AIHC

APRIL 10, 2024

Checklist for Individual & Small Group Practices Written by: Nancie Lee Cummins, CFE, CHA, CIFHA, OHCC, CHCM, CHCO, CORCM This article provides an overview of Health Information Technology for Economic and Clinical Health Act (HITECH) and basic checklist of policies and procedures for compliance of smaller health care organizations.

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Compliance US Department of Health and Human Services HIPAA Electronic Medical Records 99

Verisys

JANUARY 6, 2022

Federal payments for healthcare services account for 28% of all healthcare spending in the United States. Payments from Medicare, Medicaid, TRICARE, CHIP, and other federal programs are a significant source of funds for nearly every healthcare organization and provider. There are two types of OIG exclusions : permissive and mandatory.

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US Department of Health and Human Services Fraud Medicaid Medicaid 52

Med-Net Compliance

JULY 19, 2022

In order to participate in the Medicare, Medicaid, and all federal healthcare programs once the term of exclusion ends, the individual or entity must apply for reinstatement and receive written notice from OIG that reinstatement has been granted. An individual or entity with a defined period of exclusion (e.g., 5 years, 10 years, etc.)

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US Department of Health and Human Services Licensing Medicare Medicare 59

MedTrainer

JULY 29, 2024

Corporate compliance training software is vital to tailoring programs to staff, departments, and locations. Corporate compliance training software is vital to tailoring programs to staff, departments, and locations. Department of Health & Human Services ( HHS ).

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Compliance US Department of Health and Human Services Regulatory Compliance Compliance Officers 52

Compliancy Group

MARCH 19, 2024

Insurance carriers, cloud service providers, pharmacies, medical equipment manufacturers, and other organizations in this industry must comply with various health and safety regulations. It also reduces waste, fraud, and abuse that threaten the efficiency of healthcare delivery and services. name, phone number).

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Regulatory Compliance Compliance US Department of Health and Human Services ACA 52

Verisys

FEBRUARY 23, 2022

As government agencies and national regulatory organizations pass more regulations and the need for healthcare services grows, healthcare compliance officers (HCOs) are more important than ever. The Social Security Act establishes rules for reimbursement from Medicare, Medicaid, and CHIP. Reimbursement. Healthcare administration.

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MedTrainer

OCTOBER 16, 2023

Dive with us as we explore the complexities and necessities of compliance in the healthcare sector. Health Insurance Portability and Accountability Act (HIPAA) HIPAA is a pivotal regulation that focuses on the protection of patient health information, enforced by the U.S. Department of Health and Human Services (HHS).

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Compliance US Department of Health and Human Services HIPAA Medicaid 52

Compliancy Group

JANUARY 17, 2024

Understanding the OIG Work Plan The OIG Work Plan for physicians and health organizations is a dynamic document that lays out the various audits, reviews, and inspections the OIG intends to conduct in relation to healthcare programs and services within a time frame. HIPAA violations alone are incredibly costly to health providers.

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US Department of Health and Human Services Regulatory Compliance Compliance Regulations Compliance 52

AIHC

APRIL 10, 2024

Checklist for Individual & Small Group Practices Written by: Nancie Lee Cummins, CFE, CHA, CIFHA, OHCC, CHCM, CHCO, CORCM This article provides an overview of Health Information Technology for Economic and Clinical Health Act (HITECH) and basic checklist of policies and procedures for compliance of smaller health care organizations.

Compliance 52

Compliance US Department of Health and Human Services HIPAA Electronic Medical Records 52

MedTrainer

FEBRUARY 13, 2022

The Office of Inspector General for the Department of Health and Human Services is basically like the FBI of the HHS and they have a list of thousands of individuals and entities excluded from federally funded health care programs for a variety of reasons, including a conviction for Medicare or Medicaid fraud.

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US Department of Health and Human Services Medical Billing Hospitals Compliance 40

MedTrainer

AUGUST 8, 2022

The Office of Inspector General for the Department of Health and Human Services is basically like the FBI of the HHS and they have a list of thousands of individuals and entities excluded from federally funded health care programs for a variety of reasons, including a conviction for Medicare or Medicaid fraud.

US Department of Health and Human Services 40

US Department of Health and Human Services Medical Billing Hospitals Compliance 40

Healthcare IT News - Telehealth

SEPTEMBER 28, 2022

David Gray When President Joe Biden recently declared on national television that “the pandemic is over,” he offered a glimpse into the strategy his administration will be using on COVID-19 going forward: We’re ready to move on. What this means for telehealth and connected health policy.

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Healthcare IT News - Telehealth

SEPTEMBER 27, 2022

David Gray When President Joe Biden recently declared on national television that “the pandemic is over,” he offered a glimpse into the strategy his administration will be using on COVID-19 going forward: We’re ready to move on. What this means for telehealth and connected health policy.

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Healthcare IT News - Telehealth

JUNE 8, 2022

The Department of Health and Human Services once again (for the ninth time) extended the public health emergency this past month , stretching it beyond mid-July. But sooner or later, that provision of the Public Health Service Act will draw to a close. We spoke recently with Allison M.

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US Department of Health and Human Services Compliance COVID-19 Overpayment 209

Hall Render

APRIL 29, 2022

County Struggles with Income Affect Social Determinants of Health. HHS puts $90 million toward addressing health disparities through data. Hospitals sue HHS over Medicare billing calculation. Nearly half of rural hospitals lose money on childbirth services. Juneau clinic offers new option for treating opioid use disorder.

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

AIHC

FEBRUARY 16, 2024

Lessons Learned about Consequences & Incentives Submitted by the AIHC Education Department Introduction The Office of Inspector General has released the new General Compliance Program Guidance or “GCPG” in late 2023. One of the seven items, #5 is “Enforcing Standards: Consequences and Incentives.” The result?

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