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DOJ and HHS Announce Joint False Claims Act Working Group

The US Departments of Justice and Health and Human Services recently issued a press release on the formation of a new False Claims Act Working Group, signaling to the healthcare industry an increased focus on anti-fraud...more

HHS Rescinds Policy Extending Notice and Comment Rulemaking Procedures to Rules for Grants, Public Benefits, and Contracts

Effective March 3, 2025, the US Department of Health and Human Services (HHS) rescinded its long-standing policy that had waived a statutory exemption under the Administrative Procedure Act (APA) from notice and comment...more

Hospice Update: March Goes Out Like a Lion

The old adage—March comes in like a lion and goes out like a lamb—didn’t quite hold true for the hospice sector, which experienced a late-month flurry of activity. The government gave the hospice sector a lot to consider,...more

OIG Releases New ‘One-Stop Shop’ General Compliance Program Guidance

The US Department of Health and Human Services Office of Inspector General (OIG) released on November 6 its General Compliance Program Guidance (GCPG), a helpful new resource for the healthcare industry that consolidates...more

OIG Unveils New General Compliance Program Guidance, First Major Update Since 2008

The US Department of Health and Human Services Office of Inspector General (OIG) released its new General Compliance Program Guidance (GCPG) on November 6, 2023. The GCPG is designed to serve as a reference guide for the...more

CMS Increases Hospice Scrutiny through Provider Enrollment and Oversight Tools

The US Centers for Medicare & Medicaid Services (CMS) has implemented a final rule, effective November 13, 2023, designed to enhance the oversight of hospice providers throughout the United States and increase regulatory...more

OIG Approves Per-Click Marketing Arrangement Involving Online Healthcare Directory

The US Department of Health and Human Services Office of Inspector General (OIG) recently released Advisory Opinion No. 23-04, which found that fraud and abuse risks were sufficiently low in light of certain safeguards to...more

How the End of the PHE Will Impact the Healthcare Industry

The Biden administration announced on January 30, 2023 that the COVID-19 Public Health Emergency (PHE) would officially end on May 11, 2023. The PHE declaration, which first was issued by the Secretary of the US Department of...more

Fraud Scheme Alert for Healthcare Providers: Bogus Nursing Degrees Sold to Thousands

The US Department of Justice and Department of Health and Human Services Office of Inspector General have identified a wire fraud scheme to sell false and fraudulent nursing degree diplomas and transcripts. Coined as...more

OIG Hospice Audits of Provider Relief Fund Use Have Arrived

The HHS Office of Inspector General (OIG) has, for the last several years, been actively auditing hospices regarding their Medicare regulatory and billing compliance, with a national hospice audit in the works. Recently, OIG...more

Dobbs – US Government’s Response and Its Impact on the Healthcare Industry

Following the US Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, the federal government has issued various guidance to healthcare providers reinforcing federal legal protections or requirements...more

OIG Planning Nationwide Audit of Hospice Eligibility – What You Should Know

The HHS Office of Inspector General (OIG) recently announced its Office of Audit Services plans to conduct a nationwide review of hospice eligibility, focusing on those Medicare hospice beneficiaries who haven't had an...more

CMS Relaunches Hospice TPE Audits with Long-Stay General Inpatient Reviews

The Centers for Medicare and Medicaid Services (CMS) announced that it had restarted the Targeted Probe and Educate (TPE) audit process, effective September 1, 2021. More recently, the Medicare Administrative Contractors for...more

HHS Makes More Provider Relief Funds Available, Offers 60-Day Grace Period for First Reporting Deadline

The US Department of Health and Human Services (HHS) recently announced that it will make $25.5 billion available in new COVID-19 relief funds to providers through the Health Resources and Services Administration (HRSA). To...more

How Does Climate Change Affect the Healthcare Industry?

The US Department of Health and Human Services recently announced the establishment of the Office of Climate Change and Health Equity (OCCHE). Noting that the OCCHE is “the first office of its kind at the national level to...more

HHS Delays Provider Relief Fund Reporting Deadline

The US Department of Health and Human Services (HHS) announced on Friday, January 15, 2021, one month before the former reporting deadline, that it will push back the CARES Act Provider Relief Fund (PRF) reporting timeline...more

Hospice: Consolidated Appropriations Act Revamps Medicare Survey and Certification Process

Modifications also include public disclosure of accreditation organization survey information and intermediate civil penalty remedies for noncompliance. The Consolidated Appropriations Act, 2021 (Pub. L. 116-260), signed into...more

OIG Embraces Broader Anti-Kickback Statute Safe Harbor Protection for Warranties

The US Department of Health and Human Services’ Office of Inspector General updated the warranty safe harbor to account for bundled product and service warranties to reflect realities of healthcare product sales, but rejects...more

COVID-19: HHS Expands Phase 3 Relief Fund Provider Pool, Responds to ‘Lost Revenue’ Concerns

The US Department of Health and Human Services (HHS) issued two welcome announcements on October 22 relating to the CARES Act Relief Fund Provider Relief Fund (PRF). First, the agency expanded the pool of eligible recipients...more

Respite Care Flexibility During the COVID-19 Pandemic – A Pragmatic Legislative Fix

Imagine you are the primary caretaker for your 94-year-old terminally ill mother who lives in your home while under hospice care during the coronavirus (COVID-19) pandemic. ...more

Staying Within the Legal Lane: Providing Products and Services for COVID-19

Companies marketing products or services for coronavirus (COVID-19) should be aware of key areas of healthcare law and regulation, including Food and Drug Administration regulation, clinical laboratory testing oversight,...more

Mid-May Provider Relief Fund FAQ Updates Offer Clarification and Consternation

With just days left until provider attestations are due related to acceptance of CARES Act Provider Relief Funds, the US Department of Health and Human Services (HHS) recently updated its FAQs providing some additional...more

Recent Government Hospice Reports: Unfavorable Findings Continue

The government watchdog agencies continue to focus their attention on Medicare oversight of hospice providers, with two recent reports from the US Government Accountability Office (GAO) and the HHS Office of Inspector General...more

OIG and CMS Coordinate Seismic Change to Fraud and Abuse Laws—What It Means for the Health Industry

Highlighting the US Department of Health and Human Services’ (HHS) efforts to transform the US healthcare system to a value-based model, the Office of the Inspector General (OIG) and the Centers for Medicare and Medicaid...more

OIG Recommends Increased Oversight and Reporting Requirements for Hospice

In keeping with its recent recommendations to CMS, the Office of Inspector General for the US Department of Health and Human Services (OIG) is recommending increased oversight and compliance reporting requirements for...more

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