YouCompli

JULY 26, 2023

Fraud, waste, and abuse (FWA) associated with telehealth services existed before COVID-19, but it significantly increased during the pandemic. The audit also identified 1,714 providers whose billing for telehealth services during the first year of the pandemic posed a high risk to Medicare. million in Medicare fee-for-service payments.

Fraud 52

Fraud Compliance Medicare Medicare 52

Healthcare Law Today

JANUARY 11, 2023

The government alleged that, between April 2014 and April 2019, Jet Medical introduced devices into interstate commerce that were misbranded under the Federal Food, Drug and Cosmetic Act (FDCA) because Jet Medical did not obtain approval or clearance from the U.S. Food and Drug Administration (FDA) prior to distribution.

FDA 59

FDA Governance Medicare Medicare 59

Healthcare Compliance Blog

MAY 19, 2022

million to settle allegations that it violated the False Claims Act by submitting false claims to Medicare. The voluntary disclosure and investigation revealed that from June 1, 2013, through May 31, 2019, the hospital submitted claims to Medicare for Intensive Cardiac Rehabilitation (ICR) services provided to Medicare beneficiaries.?Before

US Department of Health and Human Services 59

US Department of Health and Human Services Hospitals Medicare Medicare 59

Health Law RX

AUGUST 10, 2023

et al , the government contends that Teva funded the copays of Medicare patients using Copaxone, a multiple sclerosis drug, through donations to nonprofits running patient assistance programs. Teva in turn allegedly benefited from these donations by increasing the cost of Copaxone to the government. The court disagreed.

Governance 52

Governance Medicare Medicare Fraud 52

Healthcare Compliance Blog

APRIL 12, 2022

By pleading guilty, the business owner admitted that she willfully failed to deposit the Federal Insurance Contributions Act and Medicare (FICA) taxes and income taxes that were withheld from her employees’ wages. However, instead of forwarding those taxes to the government, she kept them for her business.

Medical Billing 59

Medical Billing Fraud Governance Medicare 59

Healthcare Compliance Blog

APRIL 13, 2022

The two men, both 51, were convicted of criminal healthcare fraud and conspiracy charges in 2019. These included hospice and home health certifications that were material to Medicare payments. The owner is serving 240 months and was ordered to pay $120 million in restitution to the Medicare program.

Fraud 59

Fraud Medicare Medicare Compliance 59

Healthcare Law Today

DECEMBER 16, 2022

Sentencing in federal fraud cases is driven by loss amounts. To seek a higher sentencing guidelines range, the government often relies on a defendant’s “intended” loss,” rather than the “actual” loss. 2400 (2019) narrowing Auer deference applied to the Sentencing Commission’s commentary.

Fraud 52

Fraud Governance Medicaid Medicaid 52

Healthcare Compliance Blog

FEBRUARY 8, 2022

The complaint alleges that an Alabama psychiatrist caused the submission to Medicare and Medicaid of false and fraudulent claims for the prescription drug Nuedexta. From 2015 through 2019, the pharmaceutical company that manufactures Nuedexta paid the Alabama psychiatrist more than $400,000 to make speeches about Nuedexta.

Nursing Homes 52

Nursing Homes Nurses Compliance Medicare 52

Health Care Law Brief

JULY 19, 2023

Executive Health Resources affirmed the federal government’s power to dismiss a False Claims Act (“FCA”) action brought under the qui tam provisions whenever it chooses to intervene. Jesse Polansky) filed a qui tam action against Executive Health Resources for allegedly submitting fraudulent claims to the Medicare program.

Governance 52

Governance Medicare Medicare Fraud 52

Provider Trust

JULY 26, 2022

On June 7, 2022, Theresa Pickering of Norcross, Georgia was indicted by a federal grand jury on federal charges of health care fraud, aggravated identity theft, and distribution of controlled substances. In addition to these allegations of fraud, waste, and abuse, Pickering had a history of fraud.

Licensing 52

Licensing Fraud Compliance Nurses 52

AIHC

SEPTEMBER 5, 2023

Higher rates of use of telehealth are now standard in many practices since the coronavirus disease 2019 (COVID-19) pandemic. Medicare covers many telebehavioral and telemental health services including audio-only services. Store-and-forward is less commonly reimbursed by Medicare and Medicaid programs.

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COVID-19 Telemedicine Compliance Informed Consent 59

Med Law Blog

MAY 1, 2023

Christopher’s Hospital, to American Academic Health System, which then closed Hahnemann Hospital in June of 2019. Howell, Constantine Yannelis and Abhinav Gupta positing that their research shows that “PE ownership increases short term mortality of Medicare patients by 10%, in nursing homes”. in United States ex rel. Cho and Baker v.

Nursing Homes 52

Nursing Homes Malpractice Hospitals Nurses 52

Hall Render

SEPTEMBER 15, 2022

On September 2, 2022, the Office of the Inspector General (“OIG”) published a study assessing potential Medicare program integrity risks related to the proliferation of telehealth services during the first year of the COVID-19 pandemic. OIG identified 1,714 providers with billing practices deemed “high risk” to the Medicare program.

Telemedicine 40

Telemedicine Fraud Medicare Medicare 40

AIHC

MARCH 28, 2022

The complex Medicare appeals process is used to demonstrate the importance of appealing claims denied in an audit. The learning objective of this lesson is to help you become familiar with the Medicare Claims Review Program (MCRP). Other payers mirror Medicare’s program. Audited by a payer? What is an “improper” payment?

Medicare 52

Medicare Medicare Compliance Governance 52

Health Law Advisor

MARCH 7, 2023

In 2018, Congress passed requirements under the Substance Use-Disorder Prevention That Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act, requiring DEA to create a special registration for opioid addiction treatment via telehealth by October 2019. Impact on Pharmacies.

Telemedicine 52

Telemedicine COVID-19 FDA Compliance 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. Medicare Advantage and Part D) for a comprehensive assessment of a health plan’s performance. The CMS star ratings challenge. Why are CMS star ratings important?

Medicare 40

Medicare Medicare Medicaid Medicaid 40

Hall Render

AUGUST 19, 2022

Health Affairs report shows Alaskans spent more out-of-pocket dollars on health care than residents in any other state in 2019. Stockton Doctor and Medical Practice Agree to Pay Nearly $2 Million to Resolve Allegations of Health Care Fraud. UnitedHealth Group buys Medicare insurer in Texas. UC San Diego Health names new CIO.

COVID-19 40

COVID-19 Nursing Homes US Department of Health and Human Services Nurses 40

Hall Render

MARCH 31, 2023

in 2022, survey finds Senate votes to end COVID-19 national emergency Why are 600+ rural hospitals at risk of closing? County-owned buildings facing potential earthquake risk Gilead drops option to buy cancer therapeutics company Health and Life Organization Inc. buys industrial property in Rancho Cordova for $5.12

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Nurses COVID-19 40

New Jersey Healthcare Blog

JULY 22, 2022

907(b), the Department of Human Services, Division of Mental Health and Addiction Services readopted rules that govern the provision of mental health services at inpatient psychiatric hospital units known as short-term care facilities (STCFs). Bonta , 141 S. 2373 (2021) and Americans for Prosperity Foundation v. Grewal No. 191 (N.J.S.A.

COVID-19 Vaccine 40

COVID-19 Vaccine Licensing COVID-19 Public Health 40

Hall Render

APRIL 28, 2023

Luke’s hospitals getting shortchanged on government funding, lawmakers say AdaptHealth to pay $5.3M renovation Police: Man facing arson charges after setting 3 fires inside Florida hospital St. renovation Police: Man facing arson charges after setting 3 fires inside Florida hospital St.

Nurses 40

Nurses Nursing Homes COVID-19 Hospitals 40

Hall Render

JANUARY 14, 2022

CMS proposed rule seeks to lower Medicare Part D prescription drug costs. HHS secretary orders Medicare to ‘reassess’ premium increase driven by Alzheimer’s drug. Arizona asks federal government to send paramedics to help 5 Phoenix-area hospitals. Hospitals in Texas, Illinois face Medicare termination.

COVID-19 40

COVID-19 Nursing Homes Nurses COVID-19 Vaccine 40

Hall Render

JANUARY 28, 2022

Medicare posts key nursing home staffing info for consumers. Medicare scheme. Federal officials arrest nursing home owner charged with more than $3M in Arkansas Medicaid fraud. More Civil, Criminal Charges for Former Skyline CEO Accused of Tax and Medicaid Fraud. Where Hospital Price Transparency Compliance Is Lagging.

Nursing Homes 40

Nursing Homes COVID-19 US Department of Health and Human Services Nurses 40

Hall Render

FEBRUARY 4, 2022

Medicare patients win the right to appeal gap in nursing home coverage. Medicare patients win the right to appeal gap in nursing home coverage. Florida orthopedic practice more than doubles revenue since 2019 merger. Georgia nurse practitioner convicted of health care fraud in complex telemedicine fraud scheme.

COVID-19 40

COVID-19 US Department of Health and Human Services Nursing Homes Nurses 40

Hall Render

MAY 12, 2023

Mary’s Hospital opens women’s heart clinic Bills would set nurse staffing ratios in Michigan hospitals Family sues nursing home after woman chokes on food, dies Izzo name to adorn new Lansing medical center Large gift will fund cancer research at Ascension Providence Hospital Physician sentenced for billing Medicare $1.8M

COVID-19 40

COVID-19 US Department of Health and Human Services Nurses Hospitals 40

Health Populi

MARCH 29, 2019

Welcome to health politics in America as of March 2019, according to The Public and High U.S. A similar percentage overall blames waste, fraud and administrative costs in the system for high health care spending in America. As for leveraging Medicare to cover more Americans as a cost-lowering strategy, health citizens are at-odds.

Hospitals 101

Hospitals Medicare Medicare Governance 101

Drug & Device Law

JANUARY 30, 2023

2019), or Mutual Pharmaceutical Co. 470 (1996), was decided – removing express preemption as a defense for manufacturers of §510(k) products So defendants moved on fraud on the FDA under an implied preemption theory and won. Plaintiffs Legal Committee , 531 U.S. Kent , 552 U.S. Albrecht , 139 S. Bartlett , 570 U.S. Levine , 555 U.S.

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FDA Fraud Governance Medicare 72