Community Health Network (CHN) in Indiana has agreed to pay $345 million to settle false claims allegations that it paid over-the-top salaries to hundreds of physicians and rewarded them for their referrals in violation of...more
2/20/2024
/ Anti-Kickback Statute ,
Civil Monetary Penalty ,
Compensation ,
Competition ,
Compliance ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Employment Contract ,
Enforcement Actions ,
False Claims Act (FCA) ,
Fraud and Abuse ,
Health Care Providers ,
Healthcare ,
Healthcare Fraud ,
Hospitals ,
OIG ,
Physicians ,
Stark Law ,
Whistleblowers
Report on Medicare Compliance 31, no. 35 (September 26, 2022) -
For the third time in about 2 1/2 years, hospitals or other providers that are part of Dartmouth-Hitchcock Health, a large health system in New Hampshire,...more
9/29/2022
/ Centers for Medicare & Medicaid Services (CMS) ,
Civil Monetary Penalty ,
Department of Health and Human Services (HHS) ,
Diagnostic Tests ,
False Billing ,
Health Care Providers ,
Hospitals ,
Medicaid ,
Medicare ,
OIG ,
Overpayment ,
Physicians ,
Settlement ,
TRICARE
Report on Medicare Compliance 30, no. 28 (August 2, 2021) -
CMS has not fined any hospitals yet for noncompliance with price transparency requirements, a spokesperson tells RMC. “In April 2021, CMS began issuing warning...more
8/5/2021
/ Audits ,
Centers for Medicare & Medicaid Services (CMS) ,
Civil Monetary Penalty ,
Corrective Action Plans (CAPs) ,
Final Rules ,
Health Care Providers ,
Hospitals ,
Noncompliance ,
Outpatient Prospective Payment System (OPPS) ,
Price Transparency ,
Warning Letters
Report on Medicare Compliance 30, no. 22 (June 14, 2021) -
A Colorado radiation therapy provider has agreed to pay $3.569 million in a civil monetary penalty settlement with the HHS Office of Inspector General...more
6/16/2021
/ Centers for Medicare & Medicaid Services (CMS) ,
Civil Monetary Penalty ,
Department of Health and Human Services (HHS) ,
False Billing ,
Health Care Providers ,
Hospitals ,
Medicaid ,
Medical Billing Codes ,
Medicare ,
OIG ,
Overpayment ,
Physicians ,
Settlement Agreements
Report on Medicare Compliance 30, no. 11 (March 22, 2021) -
University Medical Center of Southern Nevada has agreed to pay $128,820 in a civil monetary penalty settlement that stemmed from a self-disclosure. According to...more
3/24/2021
/ Centers for Medicare & Medicaid Services (CMS) ,
Civil Monetary Penalty ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
Health Care Providers ,
Healthcare Fraud ,
Hospitals ,
Medical Billing Codes ,
Medicare ,
Medicare Beneficiaries ,
MedPAC ,
OIG ,
Physicians ,
Public Health Emergency ,
Settlement Agreements ,
Telehealth
Report on Medicare Compliance 30, no. 11 (March 22, 2021) -
A cancer center has won its appeal of $2 million in Medicare claim denials in a case about modifier 25 and the extrapolation of an overpayment. Problems with the...more
3/23/2021
/ Administrative Law Judge (ALJ) ,
Appeals ,
Billing Errors ,
Civil Monetary Penalty ,
False Claims Act (FCA) ,
Health Care Providers ,
Medicare ,
Medicare Part B ,
Medicare Prescription Drug Improvement and Modernization Act (MMA) ,
Overpayment ,
Physicians ,
Settlement
Report on Medicare Compliance 30, no. 7 (February 22, 2021) -
A Michigan woman is the first in the nation to be charged criminally with misappropriating money from the Provider Relief Fund (PRF), the Department of Justice...more
2/25/2021
/ Ambulatory Surgery Centers ,
Biden Administration ,
Centers for Medicare & Medicaid Services (CMS) ,
Civil Monetary Penalty ,
Coronavirus/COVID-19 ,
Criminal Prosecution ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Electronic Medical Records ,
Embezzlement ,
Enforcement Actions ,
Enforcement Authority ,
Health Care Providers ,
HIPAA Privacy Rule ,
HIPAA Violations ,
Home Health Care ,
Indictments ,
Medicare ,
OCR ,
OIG ,
Provider Relief Fund ,
Right of Access ,
Settlement Agreements
Report on Medicare Compliance 30, no. 4 (February 1, 2021) -
Saint Peter’s University Hospital and New Brunswick Cardiac Cath Lab LLC in New Jersey have agreed to pay $3.04 million to settle a civil monetary penalty case...more
2/3/2021
/ Anti-Kickback Statute ,
Civil Monetary Penalty ,
Department of Health and Human Services (HHS) ,
Hospitals ,
Investors ,
OIG ,
Pay-Per-Click ,
Physicians ,
Provider Self-Disclosure Protocol ,
Remuneration ,
Settlement Agreements ,
Stark Law
Report on Medicare Compliance 29, no. 45 (December 21, 2020) -
CMS said Dec. 18 it will audit a sample of hospitals for compliance with price transparency requirements, which take effect Jan. 1, according to MLN Connects....more
12/29/2020
/ American Hospital Association ,
Centers for Medicare & Medicaid Services (CMS) ,
Civil Monetary Penalty ,
Compliance ,
Department of Health and Human Services (HHS) ,
Drug Pricing ,
Health Care Providers ,
Healthcare Fraud ,
Home Health Care ,
Hospitals ,
Medicare ,
Noncompliance ,
Physical Therapists ,
Price Transparency ,
Section 340B ,
TRICARE
Report on Medicare Compliance 29, no. 20 (June 1, 2020) -
The HHS Office of Inspector General (OIG) has unveiled its “OIG Strategic Plan: Oversight of COVID-19 Response and Recovery.” Its goals are protecting people, funds...more
6/2/2020
/ Civil Monetary Penalty ,
Compliance ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
False Claims Act (FCA) ,
Health Care Providers ,
Healthcare Fraud ,
Hospitals ,
Medicare ,
OIG ,
Physicians ,
Settlement
Report on Medicare Compliance 29, no. 16 (April 27, 2020)
- The HHS Office of Inspector General (OIG) has proposed a rule on civil monetary penalties (CMPs) for information blocking and fraud related to HHS grants, contracts...more
5/5/2020
/ Audits ,
Billing Errors ,
Civil Monetary Penalty ,
Compliance ,
Data Blocking ,
Department of Health and Human Services (HHS) ,
False Claims Act (FCA) ,
Fraud ,
Kickbacks ,
Medicare ,
Medicare Billing Privileges ,
OIG ,
Physicians ,
Psychological Counseling ,
State Attorneys General ,
Telehealth
Report on Medicare Compliance 29, no. 15 (April 20, 2020)
- Maury Regional Medical Center in Tennessee has agreed to pay $1.7 million to settle false claims allegations over MS-DRG coding, the U.S. Attorney’s Office for...more
4/29/2020
/ Civil Monetary Penalty ,
Compliance ,
Department of Health and Human Services (HHS) ,
False Claims Act (FCA) ,
Hospitals ,
Laboratories ,
Medicaid ,
Medical Coding ,
Medicare ,
OIG ,
Overpayment ,
Settlement Agreements ,
TRICARE ,
Unnecessary Medical Procedures ,
Work Plans
Report on Medicare Compliance 29, no. 4 (February 3, 2020) -
? Central Coast Inpatient Consultants Inc. in California has agreed to pay $750,000 in a civil monetary penalty settlement with the HHS Office of Inspector...more
2/6/2020
/ Centers for Medicare & Medicaid Services (CMS) ,
Civil Monetary Penalty ,
Compliance ,
Enforcement Actions ,
False Claims Act (FCA) ,
HCPCS ,
Health Care Providers ,
Medicare ,
Medicare Billing Privileges ,
Medicare Fraud ,
Medicare Provider Agreements ,
OIG ,
Outpatient Prospective Payment System (OPPS) ,
Restitution ,
Settlement
Report on Medicare Compliance 29, no. 2 (January 20, 2020) -
- The HHS Office of Inspector General has updated its Work Plan, which includes an item on early discharges from inpatient rehabilitation facilities to home...more
1/27/2020
/ Civil Monetary Penalty ,
Compliance ,
Criminal Prosecution ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Durable Medical Equipment ,
False Claims Act (FCA) ,
Health Care Providers ,
Healthcare Fraud ,
Medicaid ,
Medicare ,
Medicare Fraud ,
OIG ,
Psychiatrists ,
Settlement ,
TRICARE ,
Whistleblowers
Report on Medicare Compliance 28, no. 38 (Oct. 28, 2019) -
- Doctors Hospital of Augusta in Georgia agreed to pay $180,000 in a civil monetary penalty settlement over alleged violations of the Emergency Medical Treatment...more
10/28/2019
/ Artificial Intelligence ,
Centers for Medicare & Medicaid Services (CMS) ,
Civil Monetary Penalty ,
EMTALA ,
Enforcement Actions ,
Federal Health Care Programs (FHCP) ,
Fraud Risk Indicator ,
Health Care Providers ,
Hospitals ,
Integrity Policies ,
Medicare ,
OIG ,
Physicians ,
Request For Information ,
Statutory Violations ,
Value-Based Care ,
Work Plans
- Fresenius Medical Care North America Inc. has agreed to pay $5.2 million to settle allegations that it tested dialysis patients for Hepatitis B surface antigen more often than medically necessary and billed Medicare for the...more
10/15/2019
/ Civil Monetary Penalty ,
Enforcement Actions ,
False Billing ,
False Claims Act (FCA) ,
Federal Contractors ,
Health Care Providers ,
Health Insurance Portability and Accountability Act (HIPAA) ,
HIPAA Breach ,
HIPAA Privacy Rule ,
Medical Necessity ,
Medicare ,
OCR ,
Settlement Agreements