News & Analysis as of

Audits Department of Health and Human Services (HHS) Healthcare Fraud

Groom Law Group, Chartered

The Trump Administration Implements Aggressive Medicare Advantage Plan Audits

On May 21, 2025, the Centers for Medicare & Medicaid Services (“CMS”) announced its intent “to crush[] fraud, waste, and abuse across all federal healthcare programs” through aggressive audits of Medicare Advantage (“MA”)...more

Rivkin Radler LLP

OIG Audit of MACs Finds Deficiencies

Rivkin Radler LLP on

The 12 regional Medicare Administrative Contractors (MACs) were recently audited by the U.S. Department of Health and Human Services’ Office of Inspector General (OIG). Each of the MAC jurisdictions was found by the OIG to...more

Gardner Law

Highlights from OIG’s New Compliance Program Guidance

Gardner Law on

The U.S. Department of Health and Human Services Office of Inspector General (HHS OIG) released an important new compliance resource in November 2023. The HHS OIG’s new General Compliance Program Guidance (GCPG) is intended...more

Health Care Compliance Association (HCCA)

[Event] Regional Healthcare Compliance Conference - March 1st, St. Louis, MO

Looking for compliance education and networking in your area? HCCA’s Regional Healthcare Compliance Conferences offer practitioners convenient, local compliance education on a wide variety of current and emerging topics...more

Foley & Lardner LLP

HHS OIG: New “General Compliance Program Guidance” Provides Voluntary Steps Towards Increased Effectiveness

Foley & Lardner LLP on

In connection with the November 2023 Health Care Compliance Association’s (HCCA) Healthcare Enforcement Compliance Conference, and with acknowledgment by the Chief Counsel to the Inspector General, Rob DeConti, of the long...more

Health Care Compliance Association (HCCA)

[Virtual Event] 2022 Research Conference - October 6th, 8:25 am - 4:30 pm CDT

Stay on top of the latest in research compliance - Do you want to learn: - Current best practices for building and maintaining a  research compliance work plan? - How to better shift your program’s research focus in...more

Oberheiden P.C.

5 Key Healthcare Audit Defense Strategies

Oberheiden P.C. on

Nearly all healthcare providers will face an audit (if not multiple audits) during their careers. Federal agencies such as the U.S. Department of Health and Human Services (HHS) routinely audit healthcare providers for...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 31, Number 14. News Briefs: April 2022

Report on Medicare Compliance 31, no. 14 (April 18, 2022) - Michigan gynecologic oncologist Vinay Malviya, M.D., has agreed to pay $775,000 to settle false claims allegations in connection with medically unnecessary...more

Oberheiden P.C.

Tips and Insights for Clinical Lab Compliance in 2025

Oberheiden P.C. on

The COVID-19 pandemic increased the business opportunities available to clinical labs, including molecular and respiratory labs. As the nation—and the world—struggled to develop adequate testing infrastructure, the federal...more

Goodwin

Federal Audits and Enforcement Actions of Telehealth Providers: Future Trends and Mitigating Risk

Goodwin on

As the COVID-19 pandemic progresses and the expanded use of telehealth has appeared to stabilize over the past year according to a July report from McKinsey & Company, Federal agencies have continued the recent trend of...more

Oberheiden P.C.

Seven Points to be Aware of for Durable Medical Equipment Company Compliance

Oberheiden P.C. on

Durable medical equipment (DME) is particularly important for many Medicare beneficiaries. However, companies that manufacture and sell DME need to be careful because there are strict federal regulations outlining almost...more

King & Spalding

OIG Releases Semiannual Report to Congress

King & Spalding on

On May 28, 2021, OIG released its Semiannual Report to Congress (the Report). The Report describes OIG’s work during the 6-month semiannual reporting period of October 1, 2020, through March 31, 2021 (the Semiannual Reporting...more

Society of Corporate Compliance and Ethics...

[Event] Regional Compliance & Ethics Conference - February 27th - 28th, Anchorage, AK

This two-day Regional Compliance and Ethics Conferences provide attendees with a forum to interact with local compliance professionals, share information about your compliance successes and challenges, and create educational...more

Health Care Compliance Association (HCCA)

[Event] Board & Audit Committee Compliance Conference - February 24th - 25th, Fort Lauderdale, FL

The Office of Inspector General of Health and Human Services expects board members, board audit/compliance committee members, and senior level leaders of organizations to be experienced in compliance oversight. The Board &...more

Foley & Lardner LLP

Roadmap to Prison: Lessons Learned from the Criminal Prosecution of Alpha Ambulance’s Leaders

Foley & Lardner LLP on

No one running an ambulance company ever planned to go to prison for doing his or her job. But that is a real possibility if the government knocks on the door, and the owner or manager is dishonest in his or her response to...more

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