Abby Pendleton, Esq., Adrienne Dresevic, Esq., Carey Kalmowitz, Esq., Robert Iwrey, Esq., and Jessica Gustafson, Esq. were named Attorneys of The Month by Attorney At Law Magazine and were featured on the front page and on page 16 in, “Healthy Growth: The Health Law Partners Has Rapidly Become One Of…
Health Law Attorney Blog
Answers to the Questionable PSG Billing Report Released by the OIG
Sleep testing is clearly on the Office of Inspector General’s radar. A recently released report by the agency identified nearly $17 million in questionable billing for PSG services. A lawyer analyzes the OIG’s report and provides recommendations you can implement today. In a report issued last week, the Office of…
OIG Issues Advisory Opinion Allowing Non-Profit to Bill Medicaid While Providing the Same Services for Free to Uninsured or Underinsured Children
On October 15, 2013, the Office of Inspector General for the U.S. Department of Human Services (“OIG”) issued an Advisory Opinion favorable to a non-profit health services organization’s (“Requestor’s”) proposal to provide free dental screenings and services to uninsured children while billing Medicaid for the same services provided to children…
The Individual State Health Insurance Exchanges Are Opening for Business
Among other goals, federal health care reform strives to increase the public’s access to and coverage under affordable and meaningful health insurance. The Affordable Care Act (ACA) requires most U.S. Citizens and residents to have certain minimal health insurance coverage. The individual mandate–the imposition of a penalty upon certain individuals…
“CBS Copy Machine” Investigation from 2010
Under a settlement with the U.S. Department of Health and Human Services (HHS), Affinity Health Plan, Inc. will settle potential violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy and Security Rules for $1,215,780. Affinity Health Plan is a not-for-profit managed care plan serving the New…
HLP Publishes Client Alert on 2014 IPPS Final Rule
On August 2, 2013, the Centers for Medicare & Medicaid Services (“CMS”) published its highly anticipated 2014 Inpatient Prospective Payment System (“IPPS”) Final Rule (the “2014 IPPS Final Rule”). The 2014 IPPS Final Rule will be effective on October 1, 2013. There are two main aspects of the 2014 IPPS…
NPDB Clarifies Why State Record Expungement is Not a Valid Reason to Void Data Bank Reports
The National Practitioner Data Bank (NPDB) issued a news release explaining why state record expungement is not a valid reason to void Data Bank reports. The NPDB is an electronic collection of all payments made on behalf of physicians in connection with medical liability settlements or judgments as well as…
OIG Issues June 2013 Recovery Oversight Monthly Report
The Department of Health and Human Services (HHS) Office of Inspector General (OIG) has issued its monthly Recovery Act Oversight report for June 2013. The report revealed that in June 2013, $16,937,121 of Recovery Act funds were used on Recovery Act activities. The report further indicated that to date in…
Congressional Bill Introduced to Close the In-Office Ancillary Services Exception under the Stark Law
On Thursday, August 1, 2013, Congresswoman Jackie Speier (D-CA-14) introduced the “Promoting Integrity in Medicare Act of 2013 (PIMA) in the United States House of Representatives. As the law stands, Stark Law prohibits physicians from referring Medicare patients for certain health care services in which they have a financial interest.…
OIG Reports Cancelled Elective Surgeries Cost Medicare $38.2 Million in 2009 and 2010
On August 5, 2013, the Department of Health and Human Services Office of Inspector General (OIG) released a report stating that Medicare received an estimated $38.2 million in prospective Part A inpatient hospital payments in calendar years 2009 and 2010 for short-stay, canceled elective surgery admissions that were not reasonable…