Sarah Beth S. Kuyers on Medicare

OIG Expresses Concern about Laboratory Specimen Collection Payments to Hospitals in AO 22-09

Last week, the Office of Inspector General (OIG) for the Department of Health and Human Services (HHS) issued Advisory Opinion No. 22-09 (AO 22-09), which addresses a proposed arrangement pursuant to which the operator of a...more

5/6/2022 / Anti-Kickback Statute , Department of Health and Human Services (HHS) , Department of Justice (DOJ) , False Claims Act (FCA) , Fraud , Health Insurance , Laboratories , Medicare , OIG , Payment Systems

Telehealth Reimbursement Continues to Expand for Medicare and Medicaid

Last week, the Centers for Medicare and Medicaid Services (CMS) announced additional waivers of limitations on Medicare reimbursement of telehealth services and updated its summary of COVID-19 blanket waivers. We’ve...more

5/11/2020 / Centers for Medicare & Medicaid Services (CMS) , Coronavirus/COVID-19 , Health Care Providers , Medicaid , Medicare , Physician Medicare Reimbursements , Telehealth , Telemedicine

Barriers to Telehealth Continue to Fall After CARES Act and Other Federal and State Actions

As we’ve previously discussed on the blog, telehealth is playing a critical role in delivering care during the COVID-19 pandemic. Both Congress and states continue to take action to expand the use and reimbursement of...more

4/9/2020 / CARES Act , Centers for Medicare & Medicaid Services (CMS) , Coronavirus/COVID-19 , Medicare , Telehealth , Telemedicine

Congress Loosens Telehealth Reimbursement Restrictions in Response to Coronavirus, but State Law Practice Requirements Remain

Telehealth is going to play a critical role in the delivery of care in the coming weeks and months as health care providers respond to the COVID-19 pandemic. As the CDC and other public health agencies continue to recommend...more

3/18/2020 / Coronavirus/COVID-19 , Department of Health and Human Services (HHS) , Health Care Providers , Medicare , Telehealth , Telemedicine

Third Circuit Rejects AseraCare’s “Objective Falsity” Requirement, Allows Scrutiny of Medical Opinions in Hospice False Claims Act...

Last week, the Third Circuit joined several other appellate courts in finding that medical opinions related to medical necessity of hospice services can be subject to scrutiny and found to be “false” for purposes of proving a...more

3/17/2020 / False Claims Act (FCA) , Health Care Providers , Hospice , Medicare , Objective Falsity , Physicians , Qui Tam , Relators , Scienter , Triable Issue of Fact

Key Takeaways from CMS’s Final Rule Requiring the Disclosure of Affiliates during Provider Enrollment

The Centers for Medicare & Medicare Services (CMS) recently published a final rule with comment period (the “Final Rule”) that is designed to increase CMS’s ability to identify and prevent bad actors from participating in...more

9/13/2019 / Affiliates , Bad Actors , Centers for Medicare & Medicaid Services (CMS) , Children's Health Insurance Program (CHIP) , Comment Period , Disclosure Requirements , Enrollment , Final Rules , Health Care Providers , Health Insurance , Medicaid , Medicare

OIG Reports Focus on Hospice Quality of Care

Earlier this month, the Office of Inspector General for the U.S. Department of Health and Human Services (OIG) released two reports regarding its concerns and recommendations related to quality of care at hospice facilities....more

7/26/2019 / Centers for Medicare & Medicaid Services (CMS) , Civil Monetary Penalty , Health and Safety , Health Care Providers , Hospice , Medicare , Medicare Beneficiaries , OIG , Skilled Nursing Facility , Standard of Care

A Tale of Two False Claims Act Settlements Involving EHR Vendors

Last week the Department of Justice (DOJ) announced a $57 million settlement with electronic health record (EHR) software vendor Greenway Health LLC (Greenway). According to DOJ, Greenway violated the False Claims Act (FCA)...more

2/14/2019 / Department of Health and Human Services (HHS) , Department of Justice (DOJ) , EHR , Electronic Health Record Incentives , False Claims Act (FCA) , Health Care Providers , Meaningful Use , Medicaid , Medicare , OIG , Settlement Agreements , Software , Third-Party Service Provider

Sarah Beth S. Kuyers

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