Last week, CMS posted the Preview of the Proposed Rules, which will officially be released in Federal Register format and open for comments on September 23. The proposed rule focuses on implementing the Affordable Care Act (“Act”) that will, in part: • Establish screening procedures for suppliers and providers of services participating in Medicare, Medicaid, […]
On September 15, 2010, the US Department of Health and Human Services Inspector General Daniel Levinson testified before the House Subcommittee on Health of the House Committee on Energy and Commerce regarding Medicare’s coverage of DMEPOS suppliers. Stating that DMEPOS expenditures represented 2% of all Medicare expenditures–$10 billion–in 2009, Levinson notes that there is a […]
Dr. Sam Smith Hill, III’s 2008 healthcare fraud conviction was affirmed by the 5th Circuit on August 25, 2010 (US v. Hill, No. 09-40749 (5th Cir. Aug. 25, 2010). Found guilty in five counts of healthcare fraud by a jury, Dr. Hill’s indictment alleged that he fraudulently billed Medicaid from 2001 to 2008. Having founded […]
As the Wall Street Journal reported on August 9th, health-insurance companies progressively are initiating programs to equip doctors with high-tech patient records. Even with all of the focus on electronic health records (“EHR”), an estimated 80% of U.S. physicians and 90%of hospitals continue to use paper records. As HLP has discussed in a number of […]
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 have already been issued to […]
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 company would make a monetary, […]
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 and occupational therapy schemes, home […]
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 from 1999 through 2002. As […]
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 of violations of HIPAA. Rite […]
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 residing in nursing facilities. Two […]
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