National Health Care Fraud Abuse Control Program Reports Record Recoveries and Return on Investment

Through their Health Care Fraud Abuse Control program (“HCFAC”), the United States Departments of Justice (“DOJ”) and the United States Department of Health and Human Services (“HHS”) have recovered more than $19 billion from health care providers over the last five years.  A report released on February 26 shows that the program’s three-year return on […]

Auditing the Auditors: OSC vs. OMIG

The Office of the New York State Comptroller (OSC) has just announced that it will be conducting an audit of the New York State Office of the Medicaid Inspector General (OMIG).   The audit, which is scheduled to be commenced June, is said to have been sparked by a congressional report (entitled “Billions of Federal Tax Dollars Wasted Annually […]

Exclusion From Federal Health Care Programs: New Guidance From The United States HHS OIG

The United States Department of Health and Human Services Office of the Inspector General (OIG) has issued a Special Advisory Bulletin on the Effect of Exclusion from Participation in Federal Health Care Programs (“the Bulletin”).  The Bulletin replaces the previous OIG bulletin on this topic issued in 1999.  Exclusions from federal health care programs (including […]

Proposed Rule to Extend and Amend the Exception to Donate Electronic Health Records Items and Services

The Office of Inspector General for the Department of Health and Human Services (OIG) and the Centers for Medicare and Medicaid Services (CMS) published on April 10, 2013 proposed rules to extend and amend the Electronic Health Records (EHR) donation exceptions under the Anti-Kickback Statute and Stark Law, respectively. The proposed rules would extend the […]

Brooklyn DA Creates New Healthcare Fraud Division

On Monday, Kings County District Attorney Charles J. Hynes announced the creation of a new Healthcare Fraud division within his office.  The 30-person team, headed by ADA Lauren Mack, will collaborate with federal authorities, including the United States Department of Health and Human Services Office of the Inspector General and the United States Attorney for the Eastern […]

Auditing the Auditors, Part II: New York State Senate Republicans Request Independent Audit of the OMIG

As a result of a recent Congressional report on New York State’s Medicaid program, the Legislative Gazette has reported that Senate Republican leader Dean Skelos and New York State Senate’s Republican Conference have called for an independent audit of the New York State Medicaid program. A Congressional panel had requested that federal auditors review New […]

Your Tax Dollar At Work: Fighting Medicaid Fraud, Waste, and Abuse in NYC

The New York Post has reported that the New York City Human Resources Administration (“HRA”) spent $15.6 million on Medicaid audits of providers since 2006 and has managed to recover only $11 million in misspent Medicaid funds.  The paper also reported that Medicaid Inspector General James C. Cox wrote, in a February 15, 2013 letter […]

Auditing the Auditors? Congressional Panel Requests Federal Audit of New York’s Medicaid Program

As a result of a recent Congressional report on New York State’s Medicaid program, a Congressional panel has requested that federal auditors review New York State’s $54 billion Medicaid spending and fraud, waste and abuse oversight programs. The report of the U.S. House of Representatives Committee on Oversight and Government Reform, entitled “Billions of Federal […]

Medicaid Provider Gets His Second Day In Court, Wins $7.7 Million Verdict Against His Accusers

A Brooklyn dentist who alleged that his career was ruined by a New York State Attorney General’s Office Medicaid Fraud Control Unit (MFCU) investigation has won a $7.7 million verdict against two of then-Attorney General Eliot Spitzer’s staff members. According to court papers filed by Dr. Leonard Morse’s attorney, available here, the dentist was pursued […]