Tag Archives: Fraud
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 … Continue reading
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 … Continue reading
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 … Continue reading
Quest’s Competitors File Lawsuit for Prohibited Arrangements with National Health Plans
Over the past several years, some commercial insurers have made a concerted effort to reduce costs associated with laboratory services, which physicians have increasingly relied upon in diagnosing and treating patients. In particular, insurers are concerned with the rise in … Continue reading
OMIG Releases Annual Report for Calendar Year 2011
Today, the New York State Office of the Medicaid Inspector General (“OMIG”) posted its 2011 Annual Report. We will post a detailed analysis in the coming days. In the meantime, the report may be accessed here.
New York State Allegedly Overbilled $15 Billion for State-Operated Facilities for Developmentally Disabled
On May 17, 2012, the U.S. Department of Health and Human Services, Office of Inspector General (OIG) released a report that found Medicaid overpayments to New York State-operated developmental centers. The OIG concluded that, in 2009, State-operated facilities for the developmentally disabled … Continue reading
OMIG Adopts Regulations Concerning Withholding of Medicaid Payments When Fraud Is Alleged
In accordance with federal law, the OMIG has finalized proposed regulatory changes to conform New York State law to federal law regarding the withholding of payments to Medicaid providers when there is a “credible allegation of fraud.” This requirement is … Continue reading
Legal Hurdles Mount for Lab Corp and Quest
The U.S. Department of Justice (DOJ) and the Federal Trade Commission (FTC) recently released their Annual Report for Fiscal Year 2011 under the Hart-Scott-Rodino Antitrust Act. In brief, the Hart-Scott-Rodino Act allows the DOJ and FTC to block transactions believed to be … Continue reading
Tax Dollars at Work: Federal Government Spent $102 million in Auditing Fees to Identify Less Than $20 Million in Medicaid Overpayments
The Government Accountability Office (“GAO”) has released a report following its review of the National Medicaid Audit Program. The GAO has determined that this program, designed to fight Medicaid fraud, has cost the United States at least $102 million in auditing fees … Continue reading
HHS OIG Identifies $332 Million in Uncollected Medicare Overpayments
On Friday the Office of Inspector General (“OIG”) of the Department of Health and Human Services (“HHS”) made public a report which revealed that the Centers for Medicare and Medicaid Services (“CMS”) had failed to collect over $332 million in Medicare … Continue reading
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