Federal authorities are cracking down on abuse of the HITECH Act’s Meaningful Use financial incentive program as evidenced by the recent indictment of Joe White, former CEO of Shelby Regional Medical Center (“Shelby Regional”) in Tyler, Texas. A federal grand jury indicted White on charges of making false statements to…
On January 16, 2014, the Centers for Medicare & Medicaid Services (“CMS”) announced that it will release a national provider Comparative Billing Report (“CBR”) addressing Positive Airway Pressure (“PAP”) Devices and Accessories. CMS is using CBRs as a tool to educate providers about applicable Medicare billing rules in furtherance of…
The U.S. Justice Department’s Medicare Fraud Strike Force set record numbers for health care prosecutions throughout the Country in Fiscal Year (FY) 2013. The Medicare Fraud Strike Force is a coordinated team of investigators and prosecutors from the Justice Department, the U.S. Department of Health and Human Services and the…
An article in Hospitals & Health Networks (“H&HN”), the flagship publication of the American Hospital Association, quoted HLP attorneys Abby Pendleton and Jessica Gustafson on the effects of Medicare audits on hospitals. The article, published on January 14, 2014, discusses the overwhelming burden on hospitals created by the Medicare audit…
February 28, 2014 marks the deadline for eligible professionals (“EPs”) to register and attest to demonstrating meaningful use for the 2013 Medicare Electronic Health Records (“EHR”) Incentive Program. EPs must successfully attest by 11:59 pm ET on February 28 to receive incentive payment for 2013 participation. The Medicare EHR Incentive…
In a memorandum to Office of Medicare Hearings and Appeals (“OMHA”) applicants, the Centers for Medicare and Medicaid Services (“CMS”) announced that it will temporarily suspend the assignment of new requests for Administrative Law Judge (“ALJ”) hearings for two years. CMS stated in the memo that the reason for the…
On December 26, 2013, the Department of Health and Human Services (“HHS”) and Adult & Pediatric Dermatology, P.C. (“APDerm”) agreed to settle potential violations of the HIPAA Privacy, Security, and Breach Notification Rules for $150,000. In addition the $150,00 settlement, APDerm will also be required to implement a corrective action…
On January 14, 2014, the Centers for Medicare & Medicaid Services (“CMS”) announced a new policy regarding requests made under the Freedom of Information Act (“FOIA”) on amounts paid to individual physicians under the Medicare program. This notice reverses more than 30 years of prior policy. CMS will now make…
On December 27, 2013, the Centers for Medicare & Medicaid Services (“CMS”) issued revisions to Chapter 15 of the Medicare Program Integrity Manual. The key clarifications/updates of interest to providers include: • Instructions for processing disclosures of final adverse actions reported by providers and suppliers or law enforcement agencies; •…
On December 23, 2013, the Department of Health and Human Services (“HHS”) announced the participation of 123 new Accountable Care Organizations (“ACOs”) in the Medicare Shared Savings Program. This step is intended to further advance Medicare’s goal of providing its beneficiaries with access to high-quality, coordinated care nationwide. The newly…