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

Med-Net Compliance

OCTOBER 27, 2022

Since March 2007, the Healthcare Fraud Strike Force Program, comprised of 15 strike forces operating in 24 federal districts, has charged more than 4,200 defendants who collectively have billed the Medicare program for more than $19 billion. Document that these trainings occurred and file the signed document in each employee’s education file.

Nursing Homes 59

Nursing Homes Fraud US Department of Health and Human Services Nurses 59

Health Law RX

JUNE 2, 2023

The Court’s Supervalu Decision Supervalu involved two combined FCA cases, both brought against supermarkets (Supervalu and Safeway) that house internal pharmacies and that participate with Medicare and Medicaid. [6] per 30-day supply). [9] per 30-day supply). [10] 12] The Court unanimously disagreed. per 30-day supply). [9] SuperValu Inc. ,

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

Medisys Compliance

JULY 29, 2022

As per CMS-Ruling 1536-R, effective for services on and after January 22, 2007, Medicare will allow beneficiaries to pay additional charges (which are non-covered by Medicare as these additional charges are not part of a Medicare benefit category) for insertion of an astigmatism correcting intraocular lens (AC-IOL).

Medicare 52

Medicare Medicare Medical Billing Medical Billing Outsourcing 52

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