Healthcare Law Today
JANUARY 2, 2023
As written, the proposed rule would remove the existing “reasonable diligence” standard for identification of overpayments, and add the “knowing” and “knowingly” FCA definition. And, a provider is required to refund overpayments it is obliged to refund within 60 days of such identified overpayment.
Health Law RX
MARCH 30, 2023
Setting aside the incalculable impact that litigation can have on business operations, the statute itself anticipates repayment of the proven overpayment, treble damages, and exposure to a civil statutory penalty equal to a range between $13,508 and $27,018 per false claim. As for the final judgment award, on March 17, 2023, the U.S.
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Healthcare Law Blog
FEBRUARY 3, 2023
1] Although the regulations were adopted on December 28, 2022, and became effective immediately, OMIG announced in the Compliance Program Guidance that required providers will have until March 28, 2023 , to adopt and implement the necessary changes to their compliance programs.
Health Law RX
JANUARY 30, 2024
By maintaining a robust compliance program, healthcare companies are better able to identify potential red flags early and to prevent violations of fraud and abuse laws. The DOJ Announcement stresses the importance of investing in strong compliance programs for both the buyers and sellers in business transactions.
Innovaare Compliance
MARCH 24, 2024
The Importance of Payment Integrity Payment integrity is crucial for health plans to control costs, reduce fraud, waste, and abuse (FWA), and ensure the accuracy of healthcare payments. billion in healthcare fraud judgments and settlements. billion in healthcare fraud judgments and settlements.
Health Care Law Brief
APRIL 12, 2023
The Final Rule is effective June 5, 2023. 405.986) or “reliable evidence” of fraud or “similar fault” (as defined in 42 C.F.R. 405.986) or “reliable evidence” of fraud or “similar fault” (as defined in 42 C.F.R. 79452 (2022)). 3729(b)(1)(A) of the False Claims Act (“FCA”). See Proposed Rule at 79559. See 42 U.S.C. See 42 C.F.R.
Health Law Advisor
AUGUST 25, 2023
The regulations were finalized in December 2022, with an effective date of March 28, 2023, and an enforcement moratorium that has just ended. These regulations were proposed to implement portions of the New York State 2020-2021 Budget Bill amending the mandatory compliance program requirements. The final regulations, codified at 18 N.Y.C.R.R.
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