News & Analysis as of

Health Care Providers › Audits › Reporting Requirements

Hendershot Cowart P.C.

Qlarant, Novitas Audits Escalate as Medicare Skin Substitutes Spending Hits $1.6 Billion, CMS Seeks Evidence of Clinical...

Hendershot Cowart P.C. on

The wound care industry faces unprecedented scrutiny as Medicare Part B expenditures for skin substitutes exceeded $1.6 billion in the fourth quarter of 2023 alone. The spending surge has triggered a wave of skin substitute...more

Foley & Lardner LLP

Colorado Medicaid: RAC Program Overhauled with Enhanced Transparency, Greater Provider Protections, and Increased Oversight

Foley & Lardner LLP on

In June 2025, Colorado passed a new law that makes significant changes to the state’s Medicaid Recovery Audit Contractor (RAC) program. Colorado has one of the most aggressive RAC programs in the country that has been rife...more

Rivkin Radler LLP

NYS OMIG Publishes 2025 Work Plan

Rivkin Radler LLP on

On January 29, the New York State Office of the Medicaid Inspector General (OMIG) published its 2025 Work Plan, which provides a preview of the OMIG’s program integrity initiatives for the upcoming year. While this post...more

K&L Gates LLP

Health Care Triage: Understanding OIG and CMS Audits

K&L Gates LLP on

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

BakerHostetler

[Podcast] The CARES Act Provider Relief Fund: A Moving Target

BakerHostetler on

Partner Jessica Captain Novick shares insights on the CARES Act Provider Relief Fund and what providers need to know for the requirements for general distribution funds, the relevant terms and conditions, reporting...more

Chambliss, Bahner & Stophel, P.C.

On the Horizon for 2021 — Paycheck Protection Program and Provider Relief Fund Reporting Requirements and Audits

Chambliss, Bahner & Stophel, P.C. on

If your radiology practice received payments from the U.S. Department of Health and Human Services (HHS) Provider Relief Fund (PRF) or a loan under the Paycheck Protection Program (PPP) in 2020, you are likely aware of the...more

Sheppard Mullin Richter & Hampton LLP

Department of Health and Human Services Releases New Provider Relief Fund FAQs: Reporting, Single Audits and What You Can Do Now

Sheppard Mullin Richter & Hampton LLP on

On September 19, 2020, the Health Resources and Services Administration (“HRSA”) of the Department of Health and Human Services (“HHS”) issued guidance (“September Guidance”) regarding the post-payment reporting requirements...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 29, Number 11. News Briefs: March 2020 #3

Health Care Compliance Association (HCCA) on

Report on Medicare Compliance 29, no. 11 (March 23, 2020) - There are signs of life to the national hospital reviews of short stays and high-weighted MS-DRGs (HWDRGs). A CMS spokesperson said Avar Consulting, a...more

Holland & Knight LLP

Comments on CMS Proposed Rule on Medicaid Fiscal Accountability Due Feb. 1, 2020

Holland & Knight LLP on

The Centers for Medicare & Medicaid Services (CMS) on Nov. 18, 2019, published a proposed Medicaid Fiscal Accountability rule that would amend existing regulations related to 1) base and supplemental payments, 2)...more

K&L Gates LLP

K&L Gates Triage: Internal & External Health Care Investigations Part 2

K&L Gates LLP on

In Part 2 of our series on health care investigations, Mark Rush and John Lawrence continue the discussion on internal investigations. Specifically, the episode walks through how to conduct an internal investigation,...more

Bricker Graydon LLP

Are you prepared for uncompensated care S-10 audits?

Bricker Graydon LLP on

As part of the changing calculation of the Disproportionate Share Hospital (DSH) payment adjustment, hospitals in the past several years have had to report, among other things, the amount of uncompensated and charity care...more

Foley & Lardner LLP

HHS to Collect Data From the EMS System: Good Time to Examine Accounting, Cost, Billing, and Collection Systems

Foley & Lardner LLP on

While recent legislation impacting the Emergency Medical Services (EMS)/ambulance industry drew attention inside the industry for its reduction in Health and Human Services’ (HHS) spend on non-emergent dialysis transports and...more

Womble Bond Dickinson

Next Steps: Helping Your Organization Implement the New Medicare Overpayment Rule - Part II

Womble Bond Dickinson on

On February 12, 2016, the Centers for Medicare & Medicaid Services (“CMS”) published a final rule that explains the requirements for providers and suppliers reporting and returning overpayments under Medicare Parts A & B (the...more

Burr & Forman

Meaningful Use Audits: Proactive Tips for Success

Burr & Forman on

For health care professionals who began accepting Meaningful Use incentive money at the outset of availability under the Medicare option in 2011, the year 2015 is an important year. If the provider has met all core...more

Robinson & Cole LLP

Connecticut Enacts Health Care Legislation in June Special Session

Robinson & Cole LLP on

On June 29 and 30, 2015, the Connecticut General Assembly conducted a special legislative session following the close of the 2015 regular session. Among other things, the General Assembly passed a bill to implement the state...more

15 Results
 / 
View per page
Page: of 1

"My best business intelligence, in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:
Sign up Log in
*By using the service, you signify your acceptance of JD Supra's Privacy Policy.
- hide
- hide