Healthcare Compliance Blog

JANUARY 14, 2022

million to settle allegations that the company sold custom fabricated shoe inserts to Medicare recipients that did not meet Medicare standards. Custom shoe inserts for diabetic patients can be covered by Medicare and Medicaid. A Florida based diabetic shoe company has agreed to pay over $5.5

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HIPAA Journal

JUNE 9, 2023

Prior to the Supreme Court ruling, there was no distinction between an identity thief stealing an individual’s identity and running up huge debts, a lawyer rounding up bills and only charging full hours, a waitress overcharging customers, and a doctor overbilling Medicaid. The Supreme Court decision related to the latter.

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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”). However, some drugs self-administered by Medicare beneficiaries at home are Part B eligible.

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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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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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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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Healthcare Compliance Blog

MAY 9, 2022

million to the United States government to settle claims of improperly billing the Medicare Program for home health services provided to beneficiaries living in Florida. Juan Antonio Gonzalez, US Attorney for the Southern District of Florida, stated, “The fraudulent billing of Medicare will not be tolerated.

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US Department of Health and Human Services Medicare Medicare Compliance 59

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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US Department of Health and Human Services Medicare Medicare Medicaid 59

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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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.

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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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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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FDA Licensing Medicaid Medicaid 78

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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Health Insurance Medicaid Medicaid Governance 97

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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Medval Compliance Blog

MARCH 10, 2022

by Frank Fairchok, Vice President of Medicare Reporting Services. Last week, the Centers for Medicare & Medicaid Services (CMS) advanced the rulemaking process in two long-awaited areas. 0938-AT85 – Medicare Secondary Payer and Future Medicals (CMS-6047). Figure 1 – 0938-AT85 (Click image to go to website).

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US Department of Health and Human Services Medicare Medicare Medicaid 52

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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McGuire Wood

OCTOBER 2, 2023

According to the DOJ press release, from January 2013 to July 2018, Oliver Street, doing business as U.S. The disclosure noted that claims for certain referred services were submitted for payment to Medicare, thus invoking the reach of the implicated federal laws. CMS Voluntary Self-Disclosure.

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Fraud Governance Compliance Medicare 52

Provider Trust

MAY 17, 2022

Federal regulators such as the HHS-OIG, the Department of Justice (DOJ), the Centers for Medicare and Medicaid Services (CMS), and others have regulations and guidelines regarding the prohibition of reimbursements of federal healthcare dollars (Medicaid, Medicare, CHIPS, TriCare, and others) to excluded vendors.

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Compliance Medicare Medicare Due Diligence 52

Innovaare Compliance

FEBRUARY 7, 2022

Health plans (collectively, “plan sponsors”) that contract with the Centers for Medicare & Medicaid Services (CMS) to provide health services to eligible Medicare beneficiaries are responsible for legal, contractual, and fiduciary obligations whether performed by the plan or those to whom the company delegates those obligations.

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Compliance Medicare Medicare Medicaid 52

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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Telemedicine Medicaid Medicaid Hospitals 112

HIT Consultant

APRIL 20, 2022

Since the passage of the Medicare Improvements for Patients & Providers Act in 2008, the U.S. Hospitals report the data to the Centers for Medicare & Medicaid Services (CMS), which uses that data to create the Overall Hospital Quality Star rating for each hospital. Tom Zaubler, MD, Chief Medical Officer of NeuroFlow.

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Medicare Medicare Telemedicine Medicaid 97

HIPAA Journal

OCTOBER 21, 2022

In 2013, HHS confirmed that paper-to-paper, non-digital faxes are not covered transactions). Advocates of NPIs are hoping that the introduction of Medicare Beneficiary Numbers (which went into effect in January 2020) will demonstrate to Congress that the benefits of NPIs far outweigh the costs. #4.

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HIPAA Compliance Medicare Medicare 98

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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Medicaid Medicaid Fraud Medicare 40

Verisys

NOVEMBER 14, 2023

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

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Licensing Medicaid Medicaid Governance 52

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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COVID-19 Telemedicine Electronic Medical Records Hospitals 147

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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Hospitals Payment Systems Medicaid Medicaid 40

Provider Trust

MAY 18, 2022

Additionally, check out this HHS-OIG 2016 report, Medicare: Vulnerabilities Related to Provider Enrollment and Ownership Disclosure , which revealed “vulnerabilities that could allow potentially fraudulent providers to enroll in the Medicare program.”. Moon , for submitting claims while excluded from March 2006 through July 2013.

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Compliance Due Diligence Medicaid Medicaid 52

The Health Law Firm

SEPTEMBER 23, 2013

million, according to the Department of Justice (DOJ) on September 13, 2013. The providers were accused of defrauding Medicare, Medicaid and TRICARE by performing unnecessary and improperly supervised procedures from 2007 until 2011. Indest III, J.D.,

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Fraud Medicaid Medicaid Medicare 40

The Health Law Firm

AUGUST 21, 2013

Board Certified by The Florida Bar in Health Law On August 19, 2013, Shands Healthcare agreed to pay $26 million to settle a lawsuit that stemmed from a whistleblower/qui tam claim. Indest III, J.D.,

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CMS.gov

MARCH 1, 2019

Administrator, Centers for Medicare & Medicaid Services. Medicare Parts A & B. My primary mission as the Administrator of the Centers for Medicare and Medicaid Services (CMS) is to deliver on President Trump’s commitment to strengthen and modernize Medicare for the millions of Americans who depend on us every day. .

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Healthcare Law Blog

MAY 31, 2022

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. Which regulations are implicated will depend upon how those services are rendered, as well as how those services are funded and paid. 1, 2021). [2]

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FDA HIPAA Medicare Medicare 90

Hall Render

DECEMBER 5, 2022

The Centers for Medicare and Medicaid Services (“CMS”) published a recent Memo reminding hospitals and other Medicare certified health care entities of their regulatory obligation to maintain a safe setting for patients, residents and staff. CMS’s action comes at a time when violence in health care settings is on the rise.

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Hospitals Medicare Medicare Patient Satisfaction 45

Verisys

JANUARY 18, 2022

All state-level Federal Healthcare Entitlement Program (FHEP) sources including state Medicaid exclusions, state Contractor Disqualification/Debarment lists, HEAT Task Force News, state Attorney General News, Federal District – Attorney General News, and Medicare/Medicaid opt-out lists. ISO 27001:2013 (information security).

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Licensing Medicaid Medicaid Governance 52

Pharmacy Law Blog

MARCH 13, 2018

The relator McKenzie Stepe, a former RS sales representative, originally filed her complaint in December 2013. She accused RS and Gobea of charging Tricare, Medicare and Medicaid excessively high rates for certain compounded drugs. The Relator’s FCA Suit.

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Fraud Governance Licensing FDA 52

Healthcare Law Blog

APRIL 6, 2022

On April 1, 2022 , the Centers for Medicare & Medicaid Services (“CMS”) announced states may seek to extend Medicaid postpartum coverage from 60 days to one year through a new state plan option offered by the American Rescue Plan Act (“ARPA”). This option is available for five years and ends on March 31, 2027.

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Medicaid Medicaid ACA Public Health 52

CMS.gov

MARCH 6, 2013

By: Christine Stahlecker, Director, Administrative Simplification Group, Office of E-Health Standards and Services, Centers for Medicare & Medicaid Services. These requirements are in place to lower costs, create uniform electronic standards, and streamline exchanges between health care providers and payers.

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New Jersey Healthcare Blog

JANUARY 12, 2022

1846(a), the Department of Human Services, Division of Medical Assistance and Health Services published a notice of readoption of New Jersey Care … Special Medicaid Programs Manual. The Manual extends Medicaid eligibility to certain persons not eligible under the provisions at N.J.A.C. On November 1, 2021, at 53 N.J.R.

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