On 5 March 2024, in an issue of first impression in the District of South Carolina, a district court judge overseeing judicial review of a final agency decision in a Medicare claims appeal ordered the Government to complete...more
In this episode, Stephen Bittinger and Nathan Huff discuss the growth of Medicare Part C (Medicare Advantage), new enforcements for Medicare Advantage Organization fraud, recent cases of False Claims Act liability, and key...more
Over the COVID-19 pandemic, telehealth has evolved from an infrequent method of providing health care services that was often abused into a vital tool used by providers to connect with patients. This article examines...more
Richard Church interviews Stephen Bittinger about the scope and authority of OIG and CMS audits, outlining the similarities and differences between the two from a provider perspective. The presenters discuss the key...more
In this week’s episode, Richard Church interviews Stephen Bittinger about current trends and points of concern in the areas of health care reimbursement and integrity audit activity. The presenters discuss increases in...more
The Department of Veteran Affairs (VA) has long outsourced care for veterans that the VA could not provide and for veterans’ emergency care (community care). Over the past decade, the VA has experienced significant...more
Since 30 March 2020, the Centers for Medicare & Medicaid Services (CMS) exercised enforcement discretion to suspend most Medicare Fee-For-Service medical reviews and relax related requirements during the COVID-19 public...more
In this week’s episode, Stephen Bittinger discusses the impending resumption of Medicare error-based audits, which were temporarily suspended following the onset of the COVID-19 crisis. Mr. Bittinger discusses the different...more
7/17/2020
/ Audits ,
Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Fee-for-Service ,
Health Care Providers ,
Hospitals ,
Medical Review Officers (MROs) ,
Medicare ,
Physicians ,
Public Health Emergency ,
Regulatory Requirements
On 19 June 2020, in a major reversal of the U.S. Department of the Treasury’s (Treasury) previous position, the U.S. Small Business Administration (SBA) and Treasury announced that they will publicize additional data...more
6/26/2020
/ Borrowers ,
CARES Act ,
Coronavirus/COVID-19 ,
False Claims Act (FCA) ,
Fraud ,
Health Care Providers ,
Investigations ,
Liability ,
Loans ,
Paycheck Protection Program (PPP) ,
Public Information ,
SBA