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Government Investigations Centers for Medicare & Medicaid Services (CMS)

Husch Blackwell LLP

False Claims Act Insights - How Payment Suspensions Can Impact FCA Litigation

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Host Jonathan Porter welcomes to the show Husch Blackwell partner Bryan Nowicki, a Madison-based member of the firm’s Healthcare group, to discuss payment suspensions involving the Centers for Medicare & Medicaid Services...more

Holland & Knight LLP

Final Medicare Overpayment Rules a Mixed Bag for Providers

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The Centers for Medicare & Medicaid Services (CMS) released highly anticipated updates this month to the Medicare regulations interpreting the federal 60-day overpayment refund requirement (the Overpayment Statute). The...more

Arnall Golden Gregory LLP

Second Circuit Rules That “Complaint Surveys” Are Not “Surveys” Under the Statutory Provision Requiring RNs on a Survey Team

All Medicare-certified skilled nursing facilities (“SNFs”) must be surveyed annually and not more than every 15 months, as well as on other occasions, such as for complaint investigations and revisits to determine compliance...more

BakerHostetler

Healthcare Providers Beware: Finalized Disincentives Sharpen the Teeth of Information Blocking Rule

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On June 24, 2024, the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) at the Department of Health and Human Services (HHS) issued the 21st...more

BakerHostetler

Government Scrutiny Expected of Providers That Furnished OTC COVID-19 Tests to Medicare Patients

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In April 2022, CMS announced an initiative to pay for Medicare beneficiaries to receive free OTC COVID-19 test kits. Specifically, Medicare established a demonstration project to pay various eligible healthcare providers to...more

Benesch

Dialysis & Nephrology Digest - April 2023

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ME trial reminiscent of DaVita anti-poaching case that also ended in acquittal; DOJ strategy questioned - In Apr. 2022, juries in TX and CO acquitted healthcare companies charged by the DOJ’s Antitrust Division. In the CO...more

Gardner Law

Anti-Fraud & Sunshine Update

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Staying up-to-date with fraud enforcement trends and recent cases and settlements can sometimes be viewed as a “Glass Half Empty” perspective, focusing on negative aspects of the industry and the perceived threat of...more

Arnall Golden Gregory LLP

DOJ Continues Its Annual Coordinated Healthcare Fraud Takedown

In a continuation of its annual rite, the Department of Justice (“DOJ”) on July 20, 2022, announced healthcare-related criminal charges against 36 defendants in 13 federal districts around the U.S. The charges allege more...more

Oberheiden P.C.

Federal Government Targets Providers Administering Amniotic Injections

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The federal government has recently made clear its intention to go after healthcare providers who provide amniotic injections to certain Medicare and Medicaid recipients. Over recent years, the federal government has...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 30, Number 32. News Briefs: September 2021

Report on Medicare Compliance 30, no. 32 (September 13, 2021) - Saint Francis Medical Center in Missouri agreed to pay $1.625 million in a civil settlement of allegations it violated the Controlled Substances Act, the...more

Health Care Compliance Association (HCCA)

[Event] 2022 Managed Care Compliance Conference - January 30th - February 1st, Phoenix, AZ

Attend our annual event for those who manage compliance at health plan providers. Explore topics and issues that are pertinent to industry professionals like you. Learn the latest practices, share strategies, and connect with...more

Bass, Berry & Sims PLC

Private Equity Dealmakers Guidebook to Healthcare M&A During the Covid-19 Pandemic

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The COVID-19 pandemic has stressed the M&A market at every stage of the deal-making process – from complicating on-site visits and intensifying the diligence process to introducing valuation gaps (relative to pre-COVID-19...more

Arnall Golden Gregory LLP

COVID Investigations Raise Questions About Oversight and Enforcement Before the Pandemic

On September 3, 2020, Special Agents of the Federal Bureau of Investigation, Department of Health and Human Services Office of Inspector General, and the Internal Revenue Service, along with investigators from the...more

Baker Donelson

CMS Announces Changes to Five Star Quality Rating System for Nursing Homes and Responds to FAQs

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Five Star Quality Rating System Changes - On March 23, 2020, the Centers for Medicare and Medicaid Services (CMS) announced that it was temporarily postponing routine facility inspections for nursing homes so it could...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 29, Number 10. News Briefs: March 2020 #2

Report on Medicare Compliance 29, no. 10 (March 16, 2020) - ? Millennium Physicians Association PLLC, which owns two sleep centers in the Houston area, has paid $1,248,964 to settle false claims allegations over sleep...more

Herbert Smith Freehills Kramer

SEC-Mylan Settlement: The SEC Filed Suit Regarding Investigation Disclosure

On Sept. 27, 2019, the Securities and Exchange Commission (SEC) announced that Mylan N.V., a global pharma company that manufactures and sells EpiPen, which is used to treat serious allergic reactions, agreed to pay $30...more

Health Care Compliance Association (HCCA)

[Event] Clinical Practice Compliance Conference - October 27th-29th, Nashville, TN

Our annual Clinical Practice Compliance Conference provides information about the latest government initiatives related to physicians and clinics. Unite with your colleagues to discuss strategies for facing compliance issues...more

Dorsey & Whitney LLP

Federal Government’s Charges against 60 Medical Personnel for Illegal Prescribing and Distributing of Opioids Demonstrates...

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Today, the Federal Government announced enforcement actions against 60 defendants in eleven federal districts, including 31 doctors, seven pharmacists, eight nurse practitioners, and seven other licensed medical professional...more

Mintz - Health Care Viewpoints

The OIG Identifies “Significant Vulnerabilities” in the Medicare Hospice Program: What This Might Mean for Hospice Providers?

Last week, the Department of Health and Human Services – Office of Inspector General (“OIG”) released a portfolio report identifying multiple vulnerabilities in the Medicare Hospice Program (the “Hospice Portfolio Report”),...more

Bradley Arant Boult Cummings LLP

Legal Implications and Initial Takeaways from the Equifax Data Breach

On September 7, Equifax, one of three nationwide credit-reporting agencies that compile and evaluate the financial history of consumers, announced that it suffered a security breach in which sensitive information of...more

Sheppard Mullin Richter & Hampton LLP

Medicare Advantage Plans Under Fire: The Department of Justice Files Complaints-in-Intervention

As reported in earlier blogs, the federal Department of Justice (DOJ) has been actively looking into potential abuses by Medicare Advantage (MA) Organizations as to allegedly improper risk adjustment claims submissions and...more

Jackson Walker

Legal Risks Facing Nursing Home Providers and Reducing Risk with Clinical Documentation

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Documentation in Electronic Health Records: - Nursing homes lag behind other providers in electronic health record system adoption - Of 472 nursing homes in New York, there was a 7.7 percent increase in EHR adoption...more

Poyner Spruill LLP

Corridors September 2015 - News for North Carolina Hospitals

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This article will provide an outline of some of the most significant points for hospitals to use when confronted with a formal government investigation under the Criminal or Civil False Claims Act. As noted below, you should...more

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