Health Care Law Brief

JUNE 5, 2023

In 2013, Jelly Bean contracted with the Florida Health Kids Corporation (“ FHKC ”)—a state-created entity that offers health and dental insurance for Florida children—to create, host, and maintain HealthyKids.org, where, in part, parents and others could apply for state Medicaid insurance coverage for eligible children.

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The Health Law Firm

AUGUST 26, 2013

An investigation by the Florida Attorney General’s (AG) Medicaid Fraud Control Unit (MFCU) uncovered almost $600,000 in alleged Medicaid fraud. According to the AG, a pharmacist and owner of a Hialeah, Florida, pharmacy, was arrested on August 22, 2013. Click here to read the press release from the AG.

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The Health Law Firm

FEBRUARY 21, 2014

Board Certified by The Florida Bar in Health Law A licensed speech therapist faces up to five years in prison for allegedly defrauding Medicaid during the summer of 2013. Indest III, J.D., Click here to read the press release from the AG.

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Healthcare It News

JUNE 3, 2022

Since California expanded health coverage under the Affordable Care Act, a large number of people have been mistakenly bounced between Covered California, the state’s marketplace for those who buy their own insurance, and Medi-Cal, the state’s Medicaid program for low-income residents. “This shouldn’t be happening.

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CMS.gov

OCTOBER 2, 2018

Better Data Will Serve as the Foundation in Modernizing the Medicaid Program. Administrator, Centers for Medicare & Medicaid Services. Medicaid & CHIP. Better Data Will Serve as the Foundation in Modernizing the Medicaid Program. Between 2013 and 2016, Federal spending on Medicaid grew by over $100 billion.

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MedTrainer

NOVEMBER 27, 2023

The Department of Community Health (DCH) serves as the lead agency for Medicaid and PeachCare for Kids® , and also oversees the State Health Benefit Plan , Healthcare Facility Regulation Division and State Office of Rural Health. The Medical Assistance Plans Division oversees Georgia’s Medicaid and PeachCare for Kids® programs.

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Med-Net Compliance

SEPTEMBER 9, 2022

to resolve allegations that they submitted false claims to Medicare and Medicaid. Issue: It is illegal to submit claims for payment to Medicare or Medicaid that you know or should know are false or fraudulent. A West Virginia ophthalmologist and his practice have paid $907,074.64

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American Medical Compliance

JANUARY 9, 2024

Through Medicare, Medicaid, and the Children’s Health Insurance Program, the federal government and state governments offer health care coverage to nearly 100 million individuals. This type of theft is just one example of healthcare fraud. trillion in 2015.

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The Health Law Firm

JULY 8, 2013

Board Certified by The Florida Bar in Health Law The owner of a Lake County, Florida, medical center was arrested by the Attorney General’s (AG) Medicaid Fraud Control Unit (MFCU) on June 27, 2013, for allegedly committing $300,000 in Medicaid fraud. Indest III, J.D., To read the press release from the AG, click here.

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HIT Consultant

AUGUST 17, 2023

They also serve a majority of Medicaid and non-insured patients, which makes it harder to keep the doors open on maternity wards, whose cost of upkeep can be substantial. Incentivizing Medicaid capture. Hospitals in under-resourced areas have less to offer new doctors in terms of equipment, support, and quality of life.

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The Health Law Firm

SEPTEMBER 20, 2013

Board Certified by The Florida Bar in Health Law A Broward County, Florida, home health care company is accused of overbilling the Medicaid program for patient services by almost $500,000, according to the Sun Sentinel. Click here to read the Sun Sentinel article from September 18, 2013. By George F. Indest III, J.D.,

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The Health Law Firm

APRIL 30, 2013

As the investigation into a Central Florida mental health counselor continues, new details are emerging on the extent of the $3 million Medicaid fraud scheme. On March 27, 2013, I blogged about a registered mental health counselor arrested on charges of racketeering, Medicaid fraud and identity theft.

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Health Law Attorney

APRIL 22, 2021

President Obama issued a Sequestration Order in March 2013. In response, the Centers for Medicare & Medicaid Services (“ CMS ”) issued guidance that Medicare fee-for-service (“ FFS ”) claims with dates of service after April 1, 2013 would incur a 2% reduction in Medicare payment.

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The Health Law Firm

APRIL 22, 2013

Edna Lorraine Watkins, the owner of Homecare Unlimited, LLC, in Jacksonville, Florida, has been sentenced to six years in prison for defrauding Medicaid, according to the Florida Office of the Attorney General (AG). Watkins was sentenced on April 2, 2013. We blogged about this case in February 2013, when Ms.

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The Health Law Firm

SEPTEMBER 3, 2013

million to settle claims it overbilled Medicare and Medicaid for cancer clinical trial services that were not permitted by the Medicare and Medicaid rules. This announcement from the Department of Justice (DOJ) was released on August 28, 2013. Indest III, J.D.,

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Healthcare Compliance Blog

JANUARY 14, 2022

Custom shoe inserts for diabetic patients can be covered by Medicare and Medicaid. The United States alleges that between 2013 and 2018 the shoe company sold diabetic shoe inserts that were represented to be custom made for an individual’s foot but were actually made using generic foot models.

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Health Law Advisor

FEBRUARY 2, 2023

On February 1, 2023, the Centers for Medicare & Medicaid Services (CMS) published a final rule outlining its audit methodology and related policies for its Medicare Advantage (MA) Risk Adjustment Data Validation (RADV) program. The final rule codifies long-awaited regulations first proposed by CMS in 2018.

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The Health Law Firm

SEPTEMBER 24, 2013

Leider with The Health Law Firm will be giving a presentation on Thursday, September 26, 2013, to the members of the Medical Office Resources of Florida (MOROF) and attending health care providers. This presentation is called, “Medicare and Medicaid Audits: Ready or Not, Here They Come.” Brown and Lance O.

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CMS.gov

JUNE 25, 2019

The Medicaid program has grown from $456 billion in 2013 to an estimated $576 billion in 2016, largely fueled by a mostly federally financed expansion of the program to more than 15 million new working age adults.

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HIT Consultant

NOVEMBER 8, 2021

States can also decide how they want to determine Medicaid eligibility. While popular back in 2013, custom solutions have proven in most cases to be too costly and time-consuming to be sustainable. Consider how you want the SBM to work with Medicaid. These are just a few of the many decisions a state will need to make.

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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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MedTrainer

SEPTEMBER 8, 2023

The breach occurred in 2013 when four unencrypted laptops containing the electronic protected health information (ePHI) of over 4 million patients were stolen from an Advocate Health administrative building. Details of the settlement indicate the submission of false claims to Medicare, Medicaid, TRICARE, and FECA programs.

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Healthcare IT Today

FEBRUARY 27, 2024

HealthBeacon was founded in 2013 in Dublin, Ireland. The product is patent protected, FDA cleared, and FSA, HSA, Medicare, and Medicaid eligible. Postal Service’s approved mail-back program. HealthBeacon also provides a digital risk management platform for prescribing restricted medication to oncology patients.

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Health Populi

FEBRUARY 15, 2022

But in 2013, health equity wasn’t on anyone’s agenda. When Abner met up with investors in the venture capital community at the time, he said it was “a struggle to talk to people about a solution that focused on the underserved and Medicaid.” For example, Abner now sees that every Medicaid RFP has health equity embedded in it.

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Med-Net Compliance

OCTOBER 19, 2022

The settlement resolves allegations that between 2013 and 2020, the company paid remuneration to its home health medical directors in Oklahoma and Texas for the purpose of inducing referrals of Medicare and TRICARE home health patients. The corporate officers were previously the CEO and COO of the company.

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Healthcare IT News - Telehealth

APRIL 22, 2021

Those organizations began working together 2019, focused on a value-based payment agreement to improve care and wellness for Medicaid patients in the state. Data-intensive care management is another key component, and ChristianaCare has been focused on it since the launching its CareVio platform in 2013.

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Healthcare Compliance Blog

MAY 9, 2022

It is illegal to submit claims for payment to Medicare or Medicaid that you know or should know are false or fraudulent.?Under A home health services company headquartered in Kentucky, and its related entities, paid $2.1 Issue: All submitted claims must be accurate and truthful.

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US Department of Health and Human Services Medicare Medicare Compliance 59

Healthcare IT News - Telehealth

OCTOBER 19, 2020

In the suit, the EHR giant argues that it has used the CarePort trademark since 2013 and that in 2018 the telemedicine company changed its name from ER at Home to CarePortMD. Earlier this summer, CarePort launched a tool to help hospitals comply with the Centers for Medicare and Medicaid Services' interoperability final rules.

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The Health Law Firm

AUGUST 16, 2013

According to the Daytona Beach News-Journal, the surgeon allegedly made an initial incision into a patient’s right leg when it was suppose to be made in the left leg on July 3, 2013.

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HIPAA Journal

FEBRUARY 23, 2022

The preamble could give the impression that the Administrative Simplification provisions of HIPAA Title II will improve accessibility to and affordability of the Medicare and Medicaid programs, or that the development of a health information system would streamline the provision of healthcare between providers.

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Verisys

NOVEMBER 14, 2023

If your organization is ready to streamline and shorten your credentialing timeline, reach out today.

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The Health Law Firm

MARCH 6, 2014

Board Certified by The Florida Bar in Health Law The Centers for Medicare and Medicaid Services (CMS) continues to stop fraudulent repayment claims before they happen. The agency performed a similar enrollment moratorium in July 2013. Indest III, J.D., Click here to read the press release from CMS.

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Innovaare Compliance

MARCH 4, 2024

Until the enactment of the Medicare Modernization Act (MMA) in 2006 [1] , the Centers for Medicare & Medicaid Services does not cover most outpatient prescription drugs under Part B (“Part B drugs”). Since 2013, CMS has required drug plan sponsors to report the PRC on PDE.

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McGuire Wood

OCTOBER 2, 2023

According to the DOJ press release, from January 2013 to July 2018, Oliver Street, doing business as U.S. If the issue strictly implicates the Stark Law, an institution may use the voluntary self-disclosure protocol (SDRP) to inform the Centers for Medicare & Medicaid Services (CMS) of noncompliance.

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Healthcare IT News - Telehealth

JULY 18, 2022

"Since 2013, we had provided e-consults as one of the original AAMC Project CORE institutions," she added. "In 2019, UVA Health created a multi-stakeholder strategic plan for telemedicine.

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The Health Law Firm

AUGUST 30, 2013

Board Certified by The Florida Bar in Health Law On August 2, 2013, the Centers for Medicare and Medicaid Services (CMS) released the 2014 Inpatient Prospective Payment System (IPPS) Final Rule (the 2014 IPPS Final Rule). By Lance O. Leider, J.D., The Health Law Firm and George F. Indest III, J.D.,

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Provider Trust

MAY 18, 2022

Moon , for submitting claims while excluded from March 2006 through July 2013. In addition, the suit involved alleged submission of false claims for reimbursement to the Massachusetts Medicaid Agency. In January 2015, the OIG settled for $96,259 with a Minnesota Pharmacist, Joseph C. The defendants settled and paid $19.95

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