Med-Net Compliance

JULY 20, 2022

A federal jury convicted a New York ENT doctor for defrauding Medicare and Medicaid by causing the submission of false and fraudulent claims for surgical procedures that were not performed. Specifically, between January 2014 and February 2018, the doctor billed Medicare and Medicaid approximately $585,000 and was paid approximately $191,000.

Fraud 59

Fraud Doctors Medicare Medicare 59

Health Law RX

JUNE 2, 2023

2] Companies that regularly submit claims to the federal government are familiar with the complex maze of rules and regulations that often govern them. 6] These government payor programs limit the amount pharmacies can charge for generic medications to the “usual and customary” price. [7] per 30-day supply). [9] June 1, 2023).

Fraud 52

Fraud Governance Medicaid Medicaid 52

Health Law Advisor

AUGUST 14, 2023

1] With the end of the PHE having occurred over three months ago, that temporary waiver of sanctions ended and can no longer be relied upon for legal compliance with the Stark Law. [2] 5, 2007) (emphasis added). [5] 4] and (B) each such physician (not their staff) personally perform all DMEPOS Supplier requirements. [5] 2, 2023). [2]

COVID-19 52

COVID-19 Medicare Medicare Public Health 52

Hall Render

JUNE 7, 2023

This practice implicated the pharmacies’ contracts with Pharmacy Benefit Managers (“PBMs”) as well as Medicaid and other federal health care programs. 47 (2007), the U.S. Thus, it’s important to seek legal counsel to resolve concerns about statutory or regulatory non-compliance. 47, 70 (2007). [10] Burr , 551 U.S.

Fraud 40

Fraud Medicaid Medicaid Governance 40

Hall Render

APRIL 6, 2022

Turning to the present case, in Safeway , the relator alleged that the defendant engaged in the submission of false claims to the government when it “reported its ‘retail’ price for certain drugs as its ‘usual and customary’ price.” SuperValu Inc., of America v. Burr was applicable to lawsuits brought under the False Claims Act.

Medicare 72

Medicare Medicare Medicaid Medicaid 72

Innovaare Compliance

FEBRUARY 9, 2021

Annually, the Centers for Medicare & Medicaid Services (CMS) releases star ratings, which measure the quality of care health plans deliver for its members. Launched in 2007, star ratings enable the CMS as well as consumers to compare health plans on metrics other than cost. A&G automation with single-click compliance.

Medicare 40

Medicare Medicare Medicaid Medicaid 40

Drug & Device Law

JANUARY 25, 2024

142 (2007), mere regulation of the product or conduct at issue—the medical walker is a non-prescription, Class I medical device with general controls only—is not a basis for removal under this statute. In those cases , the question is often whether the claims put FDA compliance at issue or whether the defenses do.

Medicare 52

Medicare Medicare FDA Regulatory Compliance 52