Tag Archives: Medicare
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
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
CMS Issues Section 1135 Waivers for New York and New Jersey
The Centers for Medicare and Medicaid Services (CMS) approved waivers for New York and New Jersey under Section 1135 of the Social Security Act. The waivers ease certain legal requirements on healthcare providers who are serving those impacted by Sandy. … Continue reading
False Claims Act: Payment vs. Participation Regulations
In U.S. ex rel. Williams v. Renal Care Group, Inc. (Case No. 11-5779) (October 5, 2012), the Sixth Circuit Court of Appeals reversed a grant of summary judgment in favor of the United States on two main False Claims Act … 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
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
OMIG 2012-2013 Work Plan: A Brief Overview
“Fighting Fraud. Improving Integrity and Quality. Saving Taxpayer Dollars.” This phrase appears on each page of the newly released New York State Office of the Medicaid Inspector General (OMIG) State Fiscal Year 2012-2013 Work Plan. On the Executive Summary page, … Continue reading
NYS Department of Health to Streamline CON Approval Process
The Public Health and Health Planning Council (PHHPC) announced on Thursday, May 10, that the New York State Department of Health (DOH) will begin to streamline its process for approving Certificates of Need (CON). The Committee was careful to note … Continue reading
Department of Justice & HHS Announce Record Recoveries in 2011
On February 14, 2012, the Department of Health and Human Services (HHS) and the Department of Justice (DOJ) published a Report (a copy of which can be found here) touting recoveries of “[a]pproximately $4.1 billion stolen or otherwise improperly obtained … Continue reading
CMS Releases Proposed Rules for Reporting and Returning Medicare Overpayments for Parts A and B
The Centers for Medicare & Medicaid Services (CMS) released proposed rules (42 C.F.R. Part 401, Subpart D) for Medicare overpayments to implement section 6402(a) of the Affordable Care Act enacted in 2010. The Act requires that overpayments be reported and … Continue reading
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