Hospice Insights Podcast - Hospice Audit Updates: Hospices Fare Well in Federal Court
HHS OIG’s Nursing Facility: Industry Segment-Specific Compliance Program Guidance
Podcast - Innovations and Insights in the Palliative Care Space
Hospice Insights Podcast - Hospice Audit Updates: David Beats Goliath
False Claims Act Insights - Trump DOJ Sharpens Its Focus on Healthcare Fraud
UPIC Audits
AGG Talks: Home Health & Hospice Podcast - Episode 10: Anti-Kickback Compliance for Hospice and Skilled Nursing Providers
Healthcare Industry Segment-Specific Compliance Program Guidances (ICPGs)
Hospice Insights Podcast - One Size Doesn’t Fit All: Figuring Out What is Your Hospice+
AGG Talks: Cross-Border Business Podcast - Episode 27: U.S. Healthcare Reimbursement Guidance for Foreign Life Sciences Companies
AGG Talks: Home Health & Hospice Podcast - Episode 8: Hospice Special Focus Program: Pumping the Brakes
Hospice Insights Podcast - Meet the New Laws, Same as the Old Laws: Overpayment Recoupment Update
Podcast — Drug Pricing: How the Demise of Chevron Deference and Other Litigation May Impact the Pharmaceutical Industry
Podcast — Drug Pricing: How Are Payers Responding to the IRA?
Hospice Insights Podcast - A Rise in Medicare Deactivations: Tips for Avoiding This Financial Pain
Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 187: South Carolina Hospitals and Healthcare Industry Trends with Thornton Kirby, SCHA President
A Fond Farewell: Musings on the End of the Medicare Advantage Hospice Carve-In Demonstration
Video: Braidwood v. Becerra – Challenging the Affordable Care Act’s Preventive Services Coverage Provision – Thought Leaders in Health Law
Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 173: Improving rural health care with Dr. Kevin Bennett, the Director of the Research Center for Transforming Health and the
Medical Device Legal News with Sam Bernstein: Episode 19
Traditional Medicare (Parts A and B) and Medicare Advantage (Part C, including additional vision, dental, and hearing benefits) plans aim to provide comprehensive medical benefits to American Seniors and adults with...more
Heading into the new year, a Trump-Vance administration will control the White House and the Republicans will hold a narrow majority in both the House and Senate. This control trifecta is likely to impact both legislative and...more
Robert Clark of Pompano Beach, Florida recently pleaded guilty to his role in a Medicare fraud scheme. Clark and his co-conspirators purchased Medicare Beneficiary Identification numbers unlawfully and then billed Medicare...more
The Department of Health and Human Services, Office of Inspector General (“OIG”) recently released a favorable advisory opinion, OIG Advisory Opinion No. 24-01 (the “Opinion”), to a Medicare Supplemental Health Insurance...more
The Centers for Medicare & Medicaid Services (“CMS”) announced it is expanding access to behavioral health services for Medicare beneficiaries through intensive outpatient services coverage. In general, Medicare will cover...more
On October 11, 2023, CMS published a final rule (the Final Rule) regarding how and when CMS will impose civil monetary penalties (CMPs) for Medicare secondary payers (MSPs) that untimely report required information. The Final...more
Over the past several years, the Centers for Medicare and Medicaid Services (CMS) has expanded payment for care management and remote monitoring services in an effort to recognize and pay for non-face-to-face services that...more
Whether it's reporting to CMS, getting CMS approval, or wondering how to handle LMSAs, this webinar will help answer those questions....more
Summary - On November 1, 2022, the Centers for Medicare and Medicaid Services (CMS) published notice that it will postpone for another three months the finalization of a methodology to audit Medicare Advantage (MA)...more
The hospice election may be the single most important document for hospices since an invalid form can impact payment for a patient’s entire stay. Especially in light of a recent rise in Medicare claim denials related to the...more
Yesterday, the U.S. Department of Justice (DOJ) announced that it has filed charges against 36 defendants in relation to an alleged health care fraud scheme that resulted in approximately $1.2 billion in fraudulent payments....more
Report on Medicare Compliance 31 no. 18 (May 16, 2022) - In a new report, the HHS Office of Inspector General (OIG) said 25% of Medicare beneficiaries experienced patient harm (adverse events and temporary harm events)...more
The COVID-19 Public Health Emergency (“PHE”) fundamentally changed the healthcare industry, forcing healthcare providers and patients onto their computers and phones to enable continuation of care when patients were mandated...more
Last week, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule to repeal the Medicare Coverage of Innovative Technology (MCIT) and Definition of “Reasonable and Necessary” final rule (the “Proposed...more
In September 2020, the Centers for Medicare & Medicaid Services (CMS) proposed a new rule that would expedite Medicare coverage for medical technology approved through the Food & Drug Administration’s (FDA’s) “Breakthrough...more
The Centers for Medicare & Medicaid Services (CMS) recently issued Advisory Opinion No. CMS-AO-2021-01, clarifying that physician groups that furnish designated health services (e.g., laboratory, imaging) through wholly-owned...more
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
Report on Medicare Compliance 30, no. 8 (March 1, 2021) - According to a CMS spokesperson, “CMS has not yet determined when Targeted Probe and Educate reviews will resume.” Meanwhile, “CMS continues to temporarily pause...more
Compliance Today (November 2020) - The U.S. Department of Health & Human Services Office of Inspector General (OIG) September 2020 report titled Billions in Estimated Medicare Advantage Payments From Diagnoses Reported...more
Report on Medicare Compliance 29, no. 39 (November 2, 2020) - CMS said Oct. 28 that Medicare will pay hospitals extra when they treat inpatients with drugs or biologicals approved by the Food and Drug Administration (FDA)...more
Report on Medicare Compliance 29, no. 12 (March 30, 2020) In a March 26 email, CMS said hospitals have flexibility to deliver Medicare notices to patients with suspected or confirmed cases of COVID-19. “Hard copies of...more
Report on Medicare Compliance 29, no. 12 (March 30, 2020) A federal court on March 24 ordered CMS to let Medicare patients “challenge decisions by hospitals” to change their status from inpatients to observation, dating...more
The Centers for Medicare and Medicaid (CMS) has announced that approximately 220,000 Medicare beneficiaries’ card numbers have been compromised “by an unknown person or organization.”...more
Report on Medicare Compliance 28, no. 39 (November 4, 2019) - ? The former CEO of Putnam County Memorial Hospital in Unionville, Missouri, pleaded guilty to one count of conspiracy to commit health care fraud, the Department...more
KEY POINTS - - A new CMS Medicare Rule for Calendar Year 2020 reduces the default level of supervision required for hospital outpatient therapeutic services in all hospitals, from "direct" to "general" supervision. -...more