The Office of Inspector General (OIG) recently issued a new favorable OIG Advisory Opinion, concluding that, although the proposed arrangement (“Proposed Arrangement”) between a Medicare Supplement insurer (“MediGap Plan”)...more
This favorable OIG opinion relates to a proposed arrangement (“Arrangement”) regarding a one-time voluntary redemption offer to physician partners reaching age 67 to have their partnership units repurchased by the partnership...more
This favorable OIG opinion relates to Requestor who provides consulting services to physician practices and the Requestor’s proposed arrangement (“Proposed Arrangement”) to offer its current physician practice customers...more
The following is a summary of selected federal Department of Health and Human Services’ Office of Inspector General (OIG) reports of fraud and abuse enforcement activity across the country. The enforcement actions reported...more
1/12/2024
/ Anti-Kickback Statute ,
Compensation ,
Compliance ,
Department of Health and Human Services (HHS) ,
Enforcement ,
False Claims Act (FCA) ,
Fraud and Abuse ,
Healthcare Fraud ,
Kickbacks ,
Medical Devices ,
Medicare Fraud ,
Nursing Homes ,
OIG ,
Popular ,
Risk Assessment ,
Stark Law ,
TRICARE
This favorable OIG opinion concludes that although the proposed arrangement (“Proposed Arrangement”) to subsidize Medicare cost-sharing obligations for Medicare patients in a cardiac clinical trial (“Study”) would constitute...more
The Office of Inspector General (OIG) recently issued two identical favorable OIG Advisory Opinions, concluding that, although the proposed arrangement (“Proposed Arrangement”) between a Medicare Supplement insurer (“MediGap...more
The following is a summary of selected federal Department of Health and Human Services’ Office of Inspector General (OIG) reports of fraud and abuse enforcement activity across the country. The enforcement actions reported...more
12/8/2023
/ Anti-Kickback Statute ,
Compliance ,
Criminal Convictions ,
Department of Health and Human Services (HHS) ,
False Billing ,
Fraud and Abuse ,
Health Care Providers ,
Healthcare Fraud ,
Kickbacks ,
Medicaid ,
Medicare ,
OIG ,
Pharmaceutical Industry ,
Pharmacies
This opinion addresses a proposed arrangement (“Proposed Arrangement”) by the manufacturer of cochlear implants (“Requestor”), where the Requestor would provide certain patients who receive one of their implants with a free...more
This opinion addresses a proposed arrangement (“Proposed Arrangement”) between a multi-specialty physician practice (“Requestor”) that employs approximately 11 physician employees (“Physician Employees”). In addition to base...more
This opinion addresses a proposed agreement (“Proposed Arrangement”) between a national anatomic pathology laboratory (“Requestor”) and laboratories owned in whole or in part by physicians who may refer (“Referring...more
The following is a summary of selected federal Department of Health and Human Services’ Office of Inspector General (OIG) reports of fraud and abuse enforcement activity across the country. The enforcement actions reported...more
10/6/2023
/ Anti-Kickback Statute ,
Civil Monetary Penalty ,
Department of Health and Human Services (HHS) ,
Enforcement ,
False Claims Act (FCA) ,
Fraud and Abuse ,
Healthcare Fraud ,
Kickbacks ,
Medicare ,
Medicare Fraud ,
OIG ,
Popular ,
Self-Disclosure Requirements ,
Telemedicine ,
Wire Fraud
Harris Beach invites you to register for its 7 Element compliance program series addressing New York’s 2020 and 2022 updates to Medicaid Compliance Program requirements. Starting on August 16th, each live program will be no...more
8/10/2023
/ Anti-Kickback Statute ,
Compliance ,
Department of Health and Human Services (HHS) ,
Enforcement ,
Enforcement Actions ,
False Claims Act (FCA) ,
Fraud and Abuse ,
Health Care Providers ,
Healthcare Fraud ,
Kickbacks ,
Medicare Fraud ,
Money Laundering ,
OIG ,
Opioid ,
Risk Management ,
Telemedicine
This opinion regards a proposed restructuring of financial relationships, which includes the forgiveness of debt, between a health system and a nearby clinic.
...more
The Department of Health and Human Services’ Office of Inspector General (“OIG”) has offered an opinion on providing a gift card to certain Medicare Advantage plan enrollees who complete specific steps in an online patient...more
The following is a summary of the federal Department of Health and Human Services’ Office of Inspector General (OIG) reports of fraud and abuse enforcement activity across the country. The enforcement actions reported are...more
8/19/2022
/ Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Durable Medical Equipment ,
Enforcement ,
False Claims Act (FCA) ,
Fraud ,
Health Care Providers ,
Kickbacks ,
Medicaid ,
Medicare Fraud ,
OIG ,
Telemedicine
The following is a summary of the federal Department of Health and Human Services’ Office of Inspector General (OIG) reports of fraud and abuse enforcement activity across the country.[1] The enforcement actions reported are...more
8/3/2022
/ Anti-Kickback Statute ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Enforcement ,
ESRD ,
False Claims Act (FCA) ,
Fraud and Abuse ,
Healthcare Fraud ,
Identity Theft ,
Kickbacks ,
Medicare Advantage ,
Medicare Fraud ,
OIG ,
Opioid ,
Stark Law
The following is a summary of the federal Health and Human Services agency’s Office of Inspector General (OIG) reports of fraud and abuse enforcement activity across the country. The enforcement actions reported are based...more
7/8/2022
/ Anti-Kickback Statute ,
CARES Act ,
Centers for Disease Control and Prevention (CDC) ,
Compliance ,
Coronavirus/COVID-19 ,
Durable Medical Equipment ,
Enforcement ,
False Claims Act (FCA) ,
Fraud and Abuse ,
Healthcare ,
Kickbacks ,
Medicaid ,
Medicare ,
Medicare Advantage ,
OIG ,
Opioid ,
Popular ,
Risk Assessment ,
Skilled Nursing Facility ,
TRICARE
Department of Health and Human Services Office of Inspector General (“OIG”)
Advisory Opinion 22-13 Issued:
June 23, 2022
This opinion addresses a durable medical equipment (“DME”) manufacturer’s arrangements with...more
The following is a summary of the federal Health and Human Services agency’s Office of Inspector General (OIG) reports of fraud and abuse enforcement activity across the country. The enforcement actions reported are based...more
6/24/2022
/ Anti-Kickback Statute ,
Compliance ,
Controlled Substances ,
Department of Health and Human Services (HHS) ,
Enforcement ,
False Claims Act (FCA) ,
False Statements ,
Federal Debt Collection ,
Fraud and Abuse ,
Genetic Testing ,
Healthcare ,
Healthcare Fraud ,
Mail Fraud ,
Medi-Cal ,
Medicaid ,
Medicare Fraud ,
OIG ,
Popular ,
Risk Assessment ,
TRICARE ,
Wire Fraud