News & Analysis as of

Medical Billing Codes Healthcare Fraud

Cole Schotz

“First Do No Harm” Considerations for Healthcare Providers in Light of Historic Healthcare Fraud Enforcement Announcement by the...

Cole Schotz on

On Monday, the Department of Justice Criminal Division, led by Matthew R. Galeotti, announced its largest healthcare fraud enforcement charging individuals and entities across the globe in allegedly $14.6 billion criminal and...more

J.S. Held

Inside the Healthcare Industry: The Critical Role of Medical Coding, Billing & Nurse Review

J.S. Held on

In what is already a highly regulated industry, it is becoming increasingly difficult for healthcare organizations to navigate the growing volume, complexity and enforcement of laws, regulations and guidance that surround...more

McDermott Will & Emery

OIG Nursing Facility Compliance Program Guidance: Renewed Focus on Fraud and Abuse

McDermott Will & Emery on

The US Department of Health and Human Services Office of Inspector General’s (OIG’s) release of Nursing Facility Industry Segment-Specific Compliance Program Guidance (ICPG) for the first time since 2008 reemphasizes the...more

Health Care Compliance Association (HCCA)

[Event] Regional Healthcare Compliance Conference - October 11th, Denver, CO

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

ArentFox Schiff

Investigations Newsletter: Medical Device Manufacturer THD Pays $700,000 to Resolve FCA Allegations

ArentFox Schiff on

Medical Device Manufacturer THD Pays $700,000 to Resolve FCA Allegations - On September 6, the US Attorney’s Office for the District of Maryland announced that THD America, Inc., and its parent company, THD SpA of Italy,...more

Husch Blackwell LLP

DOJ False Claims Act Suit Against Montana Oncologist Is a Warning Sign to Busy Physicians

Husch Blackwell LLP on

On August 26, 2024, the United States Attorney’s Office for the District of Montana filed a False Claims Act (FCA) complaint against a Montana oncologist, alleging that the oncologist’s busy schedule led to excessive claims...more

Health Care Compliance Association (HCCA)

[Event] 28th Annual Compliance Institute - April 14th - 17th, Nashville, TN

Get ready to be inspired with game-changing insights and industry connections! For over two and a half decades, healthcare compliance professionals have gathered at HCCA’s Compliance Institute (CI) to share ideas, learn...more

Husch Blackwell LLP

Physician Loses Rare Criminal E/M Fraud Trial

Husch Blackwell LLP on

Evaluation and management (E/M) services have been called “the core” of healthcare billing. E/M is a catch-all claim, allowing medical professionals to bill for diagnosing or treating nearly any illness or injury. E/M is also...more

Foley & Lardner LLP

Migraine Company Fails to Avoid Own Headache: Jet Medical and Others to Pay $745,000 to Resolve Allegations that Medical Device...

Foley & Lardner LLP on

On January 4, 2023, the Department of Justice issued a press release stating that Jet Medical Inc. has agreed to pay $200,000 to resolve criminal allegations relating to a migraine headache treatment. Jet Medical and two...more

ArentFox Schiff

Investigations Newsletter: Medical Device Company to Pay Over $700,000 To Resolve Criminal Allegations

ArentFox Schiff on

Medical Device Company to Pay Over $700,000 To Resolve Criminal Allegations - On January 4, 2023, a criminal information was filed in the Southern District of Illinois, in which Jet Medical Inc. (Jet), a medical device...more

Bradley Arant Boult Cummings LLP

Medicare Advantage Programs’ Increasing Popularity Invites Heightened FCA and Regulatory Scrutiny

As Medicare Advantage attracts more eligible beneficiaries, it is also drawing attention from False Claims Act (FCA) prosecutors. In 2022, enrollment in Medicare Advantage plans reached 28.7 million Medicare beneficiaries, or...more

Oberheiden P.C.

Medicare TPE Audits: 7 Common Questions Answered

Oberheiden P.C. on

The Centers for Medicare and Medicaid Services (CMS) and its audit contractors have recently increased their use of Targeted Probe and Educate (TPE) audits to target providers suspected of improperly billing Medicare. While...more

Mintz - Health Care Viewpoints

DOJ Announces Another Wide-Ranging COVID-19 Fraud Enforcement Action

For the last few years, we have been closely monitoring and reporting on COVID-19 related fraud enforcement efforts by federal agencies. We detailed those findings in our Health Care Enforcement 2020 Year in Review & 2021...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

Rivkin Radler LLP

[Webinar] Lunch-and-Learn Series: Recent Developments in Telehealth: For the Pandemic and Beyond - November 18th, 12:00 pm - 1:00...

Rivkin Radler LLP on

Please join us as Rivkin Radler Partner Eric D. Fader provides an overview of changes in the provision of telehealth services and federal and state regulation of them, since the beginning of the COVID-19 pandemic. New rules...more

Health Care Compliance Association (HCCA)

[Virtual Event] 2021 Regional Healthcare Compliance Conference - New York - May 7th, 8:25 am - 4:30 pm EDT

Our Virtual Regional Healthcare Compliance Conferences provide updates on the latest news in regulatory requirement, compliance enforcement, and strategies to develop effective compliance programs. Watch, listen, and ask...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 30, Number 11. News Briefs: March 2021 #2

Report on Medicare Compliance 30, no. 11 (March 22, 2021) - University Medical Center of Southern Nevada has agreed to pay $128,820 in a civil monetary penalty settlement that stemmed from a self-disclosure. According to...more

Oberheiden P.C.

OIG Compliance Program for Hospitals: 8 Keys to Success

Oberheiden P.C. on

The U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) is tasked with combating fraud under Medicare, Medicaid, and other federally funded healthcare programs. ...more

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