Sat.Nov 14, 2015 - Fri.Nov 20, 2015

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OIG Annual Work Plan for 2016 Series: Spotlight on OIG Investigations and Affordable Care Act Review Part Two of Two

The Health Law Firm

By Michelle Bedoya and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law. The United States Department of Health and Human Services (HHS) Office of Inspector General (OIG) released its 2016 Annual Work Plan (Work Plan) on November 2, 2015, with an effective date of October 1, 2015. The 2016 Work Plan identifies the new and ongoing investigative, enforcement and compliance activities that the OIG will undertake.

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OIG Annual Work Plan for 2016 Series: Spotlight on Medicare and Medicaid Areas of Fraud Part One of Two

The Health Law Firm

By Michelle Bedoya and George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law. The United States Department of Health and Human Services (HHS) Office of Inspector General (OIG) released its 2016 Annual Work Plan (Work Plan) on November 2, 2015, with an effective date of October 1, 2015. The Work Plan describes more than 40 new investigations and strategic inquiries concerning pharmacy fraud and increased drug prices, among other topics.

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Eight Tips to Speed Up the Medicare Prepayment Review Process

The Health Law Firm

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Medicare providers generally recoil at the news of an impending audit. However, being notified of a prepayment review is even worse. In a prepayment review, health care providers are required to submit documentation to a contractor for the Centers for Medicare & Medicaid Services (CMS) before ever even receiving payment.

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Florida Man Sentenced to 30 Months in Prison; Four Defendants Previously Sentenced; Two Defendants Plead Guilty in $126 Million Health Fraud Scheme

The Health Law Firm

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law A federal judge decided that a Florida man convicted of conspiracy to commit health fraud will spend the next 30 months behind bars. Humberto Martinez Rodriguez was the nominee owner of two clinics involved in an elaborate fraud scheme to submit $126 million in false health care claims to private insurers.

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HIPAA Compliance: Can Your Organization Avoid Costly Government Penalties and Fines?

Colington Consulting was established in 2013 and helps organizations achieve HIPAA compliance and ensures clients stay current with the latest enforcement trends. We provide a full range of HIPAA compliance services and consulting. What separates us from our competitors is our knowledge of HIPAA compliance regulations and their application to each of our client’s particular scenarios and requirements.

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Medical Licensing Exams to Include Questions on Military Medicine, Requiring Physicians to Know Their Veterans

The Health Law Firm

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Just prior to Veteran's Day this year, an announcement was made by former US Representative and licensed clinical psychologist, Brian Baird, and his colleague, Steven Haist. Moving forward, examinations for medical students and new physicians seeking licensure will now include questions about military medicine issues.

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Head of the DOJ's Antitrust Division Raises Concerns About Two Proposed Mega-Mergers Between Leading Health Insurers

The Health Law Firm

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law Assistant Attorney General, Bill Baer, head of the Department of Justice's (DOJ) Antitrust Division, recently spoke at a Yale Law School conference about competition in the health care industry. While not singling out any specific companies, Baer seemed to repeatedly reference two proposed "mega-mergers" that are currently in the balance.