McGuire Wood

OCTOBER 2, 2023

times the amount the government believed was due to improper billing, after a voluntary disclosure to the Department of Justice (DOJ). According to the DOJ press release, from January 2013 to July 2018, Oliver Street, doing business as U.S. This settlement includes more than $5.928 million in restitution, essentially a payment of 1.49

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Fraud Governance Compliance Medicare 52

The Health Law Firm

AUGUST 19, 2013

million to settle civil allegations under the False Claims Act, according to the Department of Justice (DOJ) on August 16, 2013. The nonprofit organization is accused of fraudulently billing Medicaid and other government programs for health services provided by some of its Texas clinics between 2003 and 2009, according to the DOJ.

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Medicaid Medicaid Fraud Governance 40

Pharmacy Law Blog

MARCH 13, 2018

The federal judge refused the dismissal on the grounds that the government had sufficiently backed its allegations against both the company and its owner. The government had also adequately backed its allegations that RS knew it had been overpaid but had made no attempt to refund the difference to Tricare, according to the judge.

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Fraud Governance Licensing FDA 52

Verisys

NOVEMBER 14, 2023

A healthcare facility’s accountability and overall reputation are dependent upon rigorous credentialing processes compliant with governing regulatory bodies, such as the National Committee for Quality Assurance. Verisys’ owned and maintained Fraud Abuse Control Information System (FACIS) is a provider data supersource.

Licensing 52

Licensing Medicaid Medicaid Governance 52

Provider Trust

MAY 17, 2022

Which regulations govern vendor compliance? Finally, in order for the healthcare organization to get reimbursed by Medicare, Medicare Advantage and/or Medicaid, CHIPS or TriCare, the vendor must meet certain minimum requirements regarding safeguarding Protected Health Information (PHI). It also includes suppliers.

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Compliance Medicare Medicare Due Diligence 52

Verisys

JANUARY 18, 2022

A healthcare facility’s accountability and overall reputation are dependent upon rigorous credentialing processes compliant with governing regulatory bodies, such as the National Committee for Quality Assurance. Verisys’ owned and maintained Fraud Abuse Control Information System (FACIS) is a provider data supersource.

Licensing 52

Licensing Medicaid Medicaid Governance 52

The Health Law Firm

MARCH 4, 2013

A report released by the Government Accountability Office (GAO) on February 27, 2013, announced that Medicare will remain a "high-risk" program with respect to its fraud and waste vulnerability. Leider, J.D., The Health Law Firm.

Medicare 40

Medicare Medicare Fraud Medicaid 40

Healthcare Law Blog

MAY 31, 2022

The healthcare system in the United States is governed by an expansive network of state and federal laws, including the aforementioned HIPAA regulations. For example, services that are billed to Medicaid or Medicare must comply with regulations that may not apply to services that are paid for in cash. Healthcare Laws. 1, 2021). [2]

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HIPAA Journal

JULY 24, 2023

The team’s roles are to investigate and audit the Department’s operations to prevent fraud, waste, and abuse within the Department, and also to audit and investigate potential crimes against the Department. In addition to HHS OIG enforcement actions, Medicare Fraud Control Units (MFCUs) operate in every state and territory.

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Health Law RX

NOVEMBER 9, 2021

For the first time since 2013, on November 8, 2021, the Department of Health and Human Services Office of Inspector General (“OIG”) updated its Health Care Fraud Self-Disclosure Protocol (“SDP”). The likelihood that a self-discloser would be required to pay a damages multiplier greater than 1.5

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Fraud Overpayments Overpayment Governance 52

Hall Render

JULY 22, 2022

cancer, cardio lab fraud. Delaware Adds Centene Plan to Medicaid Managed Care Offerings. Key advocates reflect on Hawaii postpartum Medicaid coverage extension. Hospital System Says It’s Hurt by Lack of Medicaid Expansion. Medicaid expansion discussions return as Mississippi hospitals face financial struggles.

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COVID-19 Nursing Homes Nurses Hospitals 40

HIPAA Journal

MARCH 30, 2022

Had the level of abuse and fraud in the healthcare industry been allowed to continue, tens of billions of dollars would have been lost to unscrupulous actors. However, when HIPAA was passed, the standards governing health care data, patients´ rights, and the flow of information were still several years away. In March 1996, Rep.

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HIPAA Fraud Health Insurance Health Care Reform 119

CMS.gov

NOVEMBER 2, 2018

Just another name for a government-run, single payer system. Seema Verma, Administrator, Centers for Medicare & Medicaid Services . Just another name for a government-run, single payer system. Imagine funding the rest of government, from defense to education, at a level 30 percent less than today, or imagine a $2.5

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Governance Medicare Medicare ACA 55