Med-Net Compliance

OCTOBER 21, 2022

The Office of Inspector General (OIG) has recently posted the False Claims Act (FCA) settlements for FY 2022 Q1–Q4 on the risk spectrum. The government’s primary civil tool for addressing healthcare fraud is the FCA. Issue: Providers must ensure that the claims they submit to Medicare and Medicaid are true and accurate.

Fraud 59

Fraud Compliance Medicare Medicare 59

The Health Law Firm Blog

NOVEMBER 29, 2022

Board Certified by The Florida Bar in Health Law On August 24, 2022, managed healthcare company, Centene Corporation, agreed to pay $19 million to the State of Washington to settle fraud allegations. By George F. Indest III, J.D., Centene owns and operates Sunshine State Health Plan, d/b/a Sunshine Health, in Florida.

Fraud 52

Fraud Medicaid Medicaid Overpayments 52

The Health Law Firm Blog

DECEMBER 19, 2022

Board Certified by The Florida Bar in Health Law On August 24, 2022, managed healthcare company, Centene Corporation, agreed to pay $19 million to the State of Washington to settle fraud allegations. By George F. Indest III, J.D., Centene owns and operates Sunshine State Health Plan, d/b/a Sunshine Health, in Florida.

Fraud 52

Fraud Medicaid Medicaid Overpayments 52

The Health Law Firm Blog

OCTOBER 14, 2022

Board Certified by The Florida Bar in Health Law On August 24, 2022, managed healthcare company, Centene Corporation, agreed to pay $19 million to the State of Washington to settle fraud allegations. By George F. Indest III, J.D., Centene owns and operates Sunshine State Health Plan, d/b/a Sunshine Health, in Florida.

Fraud 52

Fraud Medicaid Medicaid Overpayments 52

The Health Law Firm Blog

NOVEMBER 7, 2022

Board Certified by The Florida Bar in Health Law On August 24, 2022, managed healthcare company, Centene Corporation, agreed to pay $19 million to the State of Washington to settle fraud allegations. By George F. Indest III, J.D., Centene owns and operates Sunshine State Health Plan, d/b/a Sunshine Health, in Florida.

Fraud 52

Fraud Medicaid Medicaid Overpayments 52

Healthicity

APRIL 12, 2022

The OIG’s Annual Workplan for 2022 includes the continuous auditing and monitoring of items and services.

Overpayments 52

Overpayments Overpayment Fraud Medicare 52

Healthcare IT News - Telehealth

JUNE 8, 2022

While it is important to carefully consider the most effective methods of providing care and the intended purpose behind various reimbursement, privacy, and fraud and abuse regulations, it is also clear that healthcare delivery has always and continues to evolve, and the regulatory framework needs to do the same. PTs, OTs, and SLPs).

US Department of Health and Human Services 183

US Department of Health and Human Services Compliance Overpayments Overpayment 183

Healthcare Compliance Blog

JUNE 9, 2022

Between 2017 and 2019, the man, through a group of pain clinics he controlled, caused the submission of false claims for payment to Medicare. HHS-OIG will continue to work with the US Attorney’s Office to ensure the integrity of the Medicare Trust Fund.”. He is awaiting sentencing on those charges.

US Department of Health and Human Services 59

US Department of Health and Human Services Medicare Medicare Overpayments 59

AIHC

APRIL 5, 2022

Read Part 1 entitled “ Managing Denials Is Important to Good A/R Hygiene ” posted March 22, 2022, and Part 2 entitled “ Understanding How Payers Deny Claims. Read Part 1 entitled “ Managing Denials Is Important to Good A/R Hygiene ” posted March 22, 2022, and Part 2 entitled “ Understanding How Payers Deny Claims.

Fraud 52

Fraud Compliance Medicare Medicare 52

Hall Render

DECEMBER 6, 2022

As part of the final regulations released by the Centers for Medicare & Medicaid Services (“CMS”) effective January 19, 2021, CMS finalized a new exception for arrangements where an entity pays a physician less than $5,000 over the course of a calendar year in exchange for items or services. New Exception for Limited Remuneration.

COVID-19 40

COVID-19 Hospitals Overpayments Overpayment 40

Healthcare IT Today

FEBRUARY 2, 2023

It has given every indication that it intends to investigate fraud, waste, and abuse more robustly in the foreseeable future. To that end, the agency doubled its budget for audits in 2022. The Justice Department has joined the fraud case against one large national insurer. These actions are more than just saber-rattling.

Medicare 60

Medicare Medicare Medicaid Medicaid 60

The Health Law Firm Blog

APRIL 19, 2024

Board Certified by The Florida Bar in Health Law In a possibly precedent-setting case, on November 9, 2022, for the first time, an appeals court in New Jersey ruled that plaintiffs in medical malpractice cases do not need an affidavit of merit to file claims against a [.] By George F. Indest III, J.D.,

Malpractice 52

Malpractice Overpayments Overpayment Licensing 52

AIHC

SEPTEMBER 5, 2023

Medicare covers many telebehavioral and telemental health services including audio-only services. Most private insurers and Medicaid cover telebehavioral health care, but check for reimbursement restrictions and obtain professional coding and billing guidance to avoid overpayment situations.

COVID-19 59

COVID-19 Telemedicine Compliance Informed Consent 59

The Health Law Firm Blog

JANUARY 24, 2023

Board Certified by The Florida Bar in Health Law In a possibly precedent-setting case, on November 9, 2022, for the first time, an appeals court in New Jersey ruled that plaintiffs in medical malpractice cases do not need an affidavit of merit to file claims against a [.] By George F. Indest III, J.D.,

Malpractice 52

Malpractice Overpayments Overpayment Licensing 52

Hall Render

JANUARY 19, 2024

in costs, report finds Pennsylvania hospital staff vote for union removal St.

Nursing Homes 40

Nursing Homes Nurses Hospitals COVID-19 40

Hall Render

OCTOBER 7, 2022

Hospitals likely to end 2022 in the red despite August boost, report says. Judge orders Anthem to face lawsuit over alleged Medicare overpayments. Judge rules that HHS must immediately halt unlawful reimbursement cuts to certain 340B hospitals for rest of 2022. Delaware retirees protest switch to Medicare Advantage plan.

COVID-19 40

COVID-19 Nurses Nursing Homes Hospitals 40

Hall Render

NOVEMBER 10, 2023

California physician convicted of healthcare fraud, kickbacks California’s healthcare minimum wage boost to cost $4B City Council upholds approval of Hollywood Presbyterian medical offices at 1321 N. Will it survive the next few years?

Nursing Homes 40

Nursing Homes Nurses Hospitals COVID-19 40

Hall Render

MARCH 15, 2024

expansion Legal exam removed from pharmacist certification in Michigan Michigan physician charged with fraud Physician’s union at Ascension St. Children’s National makes first high-level executive appointments under new CEO DC plans to open emergency department in one of its most underserved communities D.C.

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Nurses Hospitals 40