Attorney General of New York, Andre Cuomo, initiated an investigation into health care credit cards after receiving a substantial number of complaints from consumers who were convinced by doctors and dentists to sign up for them. The investigation will examine the financial incentives providers received from promoting the cards. Subpoenas…
On July 30, the OIG released advisory opinion no 10-11 (the “Opinion”) which favorably reviewed a company’s proposal to encourage health care providers to use its online program for scheduling meetings with manufacturer representatives by offering the health care provider an opportunity to select a public charity to which the…
As the HLP had previously reported, on July 16, the HHS Medicare Fraud Strike Force announced charges against 94 individuals for their alleged participation in schemes that collectively submitted more than $251 million in false claims to Medicare. The charges are based on a variety of schemes including: physical therapy…
On July 23, CMS published a notice in the Federal Register, soliciting proposals in a new imaging demonstration created under the Medicare Improvements for Patients and Providers Act of 2008. The two-year Medicare Imaging Demonstration (MID) will test whether the use of decision supports systems (DSSs) can improve quality of…
Advanced Radiology of Beverly Hills has agreed to pay the federal government $647,000 to settle allegations that they filed false claims with Medicare for unnecessary radiological tests. The United States civil lawsuit alleged that Advanced Radiology engaged in a scheme to bill Medicare for unnecessary tests performed at Advanced Radiology…
For those providers and entities that think HIPAA violations are no big deal or that have yet to implement required policies and procedures, they are well advised to review the Department of Health and Human Services July 27, 2010 press release announcing a $1 million dollar settlement related to allegations…
The Medicare hospice benefit is a fully reimbursable Medicare Part A benefit option, which covers the multidisciplinary services addressing the physical and emotional pain associated with terminal illness through palliative treatment. To be eligible to elect hospice care under Medicare, an individual must be entitled to Part A of Medicare,…
Governor David Paterson has called for a mandatory session with the state legislature to address the remaining portion of the state budget. This comes after local governments around New York threatened to suspend their Medicaid payments to the state as a consequence of New York’s chronic cash shortage. The special…
Hospice providers are facing ongoing claims scrutiny, highlighting the importance of compliance. On June 8, 2010, the Centers for Medicare and Medicaid Services (“CMS”) held a national outreach session to educate hospice providers regarding specific vulnerabilities involving hospice services, with specific emphasis on the provision of hospice services to beneficiaries…
Federal authorities conducted the largest Medicare fraud bust ever in five different states (including Michigan and New York), arresting dozens of suspects accused in scams totaling $251 million. In total, 94 suspects have been indicted and 36 were arrested this morning including doctors and nurses in Detroit, New York City,…