The Albany County Bar Association Newsletter includes an article written by our colleague, David Nardolillo, on a recent HIPAA-related decision from the Connecticut Supreme Court.
It’s that time of year again when Medicaid providers who are required to have an effective Medicaid Compliance Plan have to so certify to the OMIG. The on-line certification can only be done during the month of December. 2014 Compliance Program Certification information and forms for the December 2014 certification period are now posted on […]
Earlier this week, we blogged about postings found on job-search sites Monster.com and indeed.com advertising that New York State is now accepting applications for the Medicaid Inspector General, the head of the state agency charged with combating fraud, waste, and abuse in the State’s Medicaid program.
It appears that Governor Cuomo’s office is looking to replace New York State Medicaid Inspector General James C. Cox. An internet posting seeking applications for the position of the Medicaid Inspector General (MIG) was seen on Monster.com and also indeed.com.
In what could be very important news this afternoon regarding the Patient Protection and Affordable Care Act (“PPACA,” or more commonly called “Obamacare”), the Supreme Court of the United States announced that it was granting certiorari in the case of King v. Burwell, decided on July 22, 2014, by the United States Court of Appeals […]
As far as the Federal government is concerned, it appears that New York is running up quite a bill in claimed overpayments to its Medicaid program. After finding the State liable for nearly $1.26 billion in overpayments related to intermediate care facilities operated by the Office for People with Developmental Disabilities (“OPWDD”), the United States […]
The New York State Office of the Medicaid Inspector General (OMIG) has released its 2013 Annual Report (“Report”). The OMIG announced that it has recovered a record $879 million in Medicaid overbillings for 2013. More than $226 million of Medicaid overbillings were identified through audit activities. According to the Report, over the last three years, […]
The theory of “worthless services” has yet again been tried by whistleblowers in the federal False Claims Act context, this time resulting in a large settlement with the federal government. We saw this argument made previously in Ashber v. Momence, which we discussed in a prior article here. Now, Extendicare Health Services Inc., and its […]
President Obama signed into law on October 6th, 2014 the “Improving Medicare Post-Acute Care Transformation Act of 2014”, also known as the “IMPACT Act of 2014”. The IMPACT Act of 2014 amends the Social Security Act to require home health agencies, skilled nursing facilities, inpatient rehabilitation facilities, and long-term care hospitals to report on a […]
On Wednesday, October 2, the Centers for Medicare and Medicaid Services (“CMS”) issued its 2015 consultation guide for states to use when setting reimbursement rates with respect to any Medicaid managed care program subject to actuarial soundness requirements in 42 CFR 438.6 during rating periods starting January 1, 2015. The guide “describes information that CMS expects states to provide […]