The Centers for Medicare and Medicaid Services (“CMS”) defines an overpayment as a payment to a provider or supplier that exceeds the amounts payable under Medicare statutes and regulations. If CMS identifies an overpayment made to a provider or supplier, it will initiate a recovery process for those identified overpayments. CMS’ recovery process begins by […]
In August, we posted an entry regarding the newly announced Health Information Portability and Accountability Act of 1996 (“HIPAA”) audits that would be underway, pursuant to Section 13411 of the Health Information Technology for Economic and Clinical Health Act (“HITECH”). Section 13411 provides, in its entirety: SEC. 13411. AUDITS. The Secretary shall provide for periodic […]
The Medicare RAC program is expanding even further. By way of a Fact Sheet issued on November 15, 2011, CMS announced three new initiatives with respect to its Medicare RAC program. Beginning January 1, 2012, CMS will conduct demonstration projects with the goal to eliminate fraud, waste, and abuse in the Medicare program. The three […]
On July 19, 2011, the Centers for Medicare and Medicaid Services (“CMS”) published in the Federal Register its CY 2012 Physician Fee Schedule Proposed Rule (“Proposed Rule”). On November 1, 2011, CMS issued its CY 2012 Physician Fee Schedule Final Rule (“Final Rule”), in part, to “address changes to the physician fee schedule and other […]
CMS Issues 2012 Final Physician Fee Schedule. On July 19, 2011, the Centers for Medicare and Medicaid Services (“CMS”) published in the Federal Register its CY 2012 Physician Fee Schedule Proposed Rule (“Proposed Rule”). On November 1, 2011, CMS issued its 2012 Final Physician Fee Schedule (“Final Rule”), in part, to “address changes to the […]
The Balanced Budget Act of 1997 enacted the much-despised Medicare sustainable growth rate (“SGR”), which was established to control Medicare spending on physician services. To achieve the SGR target, each year in its report to the Medicare Payment Advisory Commission, the Centers for Medicare and Medicaid Services (“CMS”) includes a conversion factor that will change […]
The HLP is proud to announce that founding partner, Robert S. Iwrey, Esq., was named a d’Business Magazine Top Lawyer in Healthcare for 2012. Iwrey was also named a Top Lawyer in Healthcare in 2010. d’Business polled more than 21,000 attorneys in Oakland, Macomb, Wayne, Washtenaw and Livingston counties, asking them to nominate attorneys for […]
The Health Law Partners, P.C. is honored to be recognized by the U.S. News as a 2011-2012 “Best Law Firm” in the area of health care law. The rankings showcase law firms ranked nationally in one or more of 75 major legal practice areas. According to a press release issued by U.S. News, achieving this […]
On October 4, 2011 in Izgel Medical Services, PLLC v. CMS, the Department of Health and Human Services Departmental Appeals Board (“DAB”) held that the Centers for Medicare and Medicaid Services (“CMS”) “was authorized to revoke the Medicare provider enrollment of Petitioner, Izgel Medical Services, PLLC” for its failure to timely report to CMS a […]
Premier Home Care, a Durable Medical Equipment company operating in Indiana and Kentucky, agreed to pay a $578,820 settlement with the United States Department of Justice and the State of Indiana in a Whistleblower action alleging violations of the False Claims Act. In 2008, a former employee filed suit against Premier under seal alleging that […]
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