Health Law Advisor
AUGUST 25, 2023
Social Services Law § 363-d) codified in New York State law federal requirements and OMIG policies require Medicaid providers who have received an overpayment to report, return, and explain the overpayment by making a disclosure to OMIG within sixty (60) days of identifying the overpayment.
YouCompli
SEPTEMBER 13, 2023
Mitigating fraud, waste, and abuse (FWA) is taking on a new urgency for healthcare compliance professionals. Given the severity of penalties associated with FWA, compliance professionals’ knowledge and skills will be crucial to ensuring that their organizations avoid penalties and provide compliant patient care.
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Healthcare Law Blog
FEBRUARY 3, 2023
New Subpart 521-1: Compliance Programs The adopted regulations represent substantial changes to 18 N.Y.C.R.R. Part 521 governing the implementation and operation of effective compliance programs for certain “required providers,” including, now for the first time, Medicaid managed care organizations (MMCOs). [1]
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. Ensure Ongoing Compliance.
Compliancy Group
FEBRUARY 7, 2024
CMS UPIC audits are designed to identify and prevent fraud, waste, and abuse within Medicare and Medicaid, ensuring that federal funds are used appropriately and that the services billed for are actually provided and are medically necessary. Given their significant impact, healthcare organizations must take UPIC audits seriously.
Compliancy Group
FEBRUARY 29, 2024
A Corporate Integrity Agreement outlines the healthcare entity’s future compliance obligations and the steps to prevent future fraud, abuse, and illegal activity incidents. Being able to opt into a Corporate Integrity Agreement typically depends on the severity and nature of the infraction and the entity’s previous compliance record.
Healthcare Law Blog
FEBRUARY 9, 2024
million to resolve a lawsuit filed by the system’s former Chief Compliance Officer, Ronald Sherman. Sherman himself had submitted disclosure logs to the OIG), Sherman alleges that it failed to adequately report the arrangements it had with Neonatology Associates or any other private physician groups, or return any alleged overpayments.
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