On April 5, 2023, the Centers for Medicare & Medicaid Services (CMS) issued a Final Rule (CMS-4201-F) regarding the Medicare Advantage (MA) and Part D programs. The Final Rule includes changes related to various aspects of...more
4/10/2023
/ Centers for Medicare & Medicaid Services (CMS) ,
Continuity of Care ,
Department of Health and Human Services (HHS) ,
Final Rules ,
Health Care Providers ,
Medical Necessity ,
Medicare Advantage ,
Medicare Part D ,
OIG ,
Regulatory Agenda ,
Regulatory Requirements ,
Two-Midnight Rule
On January 9, 2020, DOJ announced it recovered more than $3 billion in settlements and judgments from civil cases involving fraud and false claims against the government in the fiscal year ending September 30, 2019. DOJ...more
1/17/2020
/ Clinical Laboratories ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Claims Act (FCA) ,
Health Care Providers ,
Healthcare Fraud ,
Hospitals ,
Pharmaceutical Industry ,
Pharmacies ,
Physicians ,
Qui Tam
On September 20, 2018, CMS published a proposed rule that the agency states is aimed at reducing the regulatory burden for providers by revising certain aspects of the Medicare Conditions of Participation and Conditions of...more
On February 9, 2018, after passing the House and Senate, the President signed into law the Bipartisan Budget Act of 2018 (BBA). The BBA amends the Budget Control Act of 2011 (BCA) to increase the spending caps on both defense...more
On October 13, 2017, a Jacksonville cardiovascular practice entered into an approximately $440,000 settlement to resolve allegations concerning violations of 42 U.S.C. 1320a-7k (the 60-Day Overpayment Rule) and its Florida...more
On September 6, 2017, CMS’s Center for Clinical Standards and Quality/Survey & Certification Group announced revisions to Appendix A of the State Operations Manual (SOM), which governs hospital surveys. The revisions are...more
On April 18, 2017, the United States District Court for the Middle District of Florida adopted the magistrate judge’s report and recommendation and granted BayCare Health System’s (BayCare’s) motion for summary judgment. The...more
On March 27, 2017, in conjunction with the Health Care Compliance Association (“HCCA”) annual Compliance Institute (“CI”), the Department of Health and Human Services (“HHS”), Office of the Inspector General (“OIG”) released...more