YouCompli

MAY 25, 2022

Just look at the rampant, unreported fraud that took down Enron in the early 2000s. In both cases, the alleged fraud could not have gotten as far as they did in an organization that valued regulatory compliance and ethical behavior. Definition of compliance culture in healthcare.

Compliance 52

Compliance Compliance Officers Regulatory Compliance Fraud 52

Health Care Law Brief

JUNE 24, 2022

In October 2021, DOJ launched the Civil Cyber-Fraud Initiative , which leverages the False Claims Act to prosecute cybersecurity violations, including related HIPAA violations. The first settlement under the Civil Cyber-Fraud Initiative occurred in March 2022—against a health care entity.

HIPAA 52

HIPAA Compliance Public Health Fraud 52

Florida Health Care Law Firm

DECEMBER 2, 2021

On November 8, 2021, The Department of Health & Human Services (HHS), Office of Inspector General (OIG) released a revised and renamed Provider Self-Disclosure Protocol (SDP), now known as the “Health Care Fraud Self Disclosure “protocol. The OIG recognized that there are benefits to disclose potential fraud.

Overpayments 40

Overpayments Overpayment Medicare Medicare 40

Healthcare Law Today

DECEMBER 12, 2022

Maureen has extensive experience handling malicious insider matters ranging from employee fraud, embezzlement, and misappropriation to breaches of non-solicitation, non-compete and confidentiality agreements. I think you see that, as Mark pointed out, with the fraud alert. regulatory focus over the next couple of years.

Telemedicine 49

Telemedicine Fraud Compliance Governance 49

Health Care Law Brief

APRIL 11, 2022

Notwithstanding these streams of remuneration taking the form of cash equivalents and not being protected by an AKS regulatory safe harbor or by an exception to the Beneficiary Inducements CMP, the OIG still concluded that the Arrangement presented a minimal risk of fraud and abuse based on a totality of the underlying facts and circumstances.

Fraud 52

Fraud Medicare Medicare Health Outcomes 52

Health Care Law Brief

MARCH 8, 2022

And, participating DCEs were provided with the added benefit and flexibility of developing and offering certain financial and other incentives protected by a fraud and abuse waiver under section 1115A(d)(1) of the Social Security Act.

Medicare 52

Medicare Medicare Fraud Compliance 52

Health Care Law Brief

JUNE 2, 2022

For example, the Department of Justice has aggressively pursued health care fraud claims against individuals and entities involved in non-compliant telehealth models. The severity and type of risk present in a telehealth business will vary—by jurisdiction, by provider type, by service offering, and by payor mix. Provider Licenses.

Public Health 52

Public Health Compliance COVID-19 HIPAA 52

Health Care Law Brief

FEBRUARY 7, 2022

It is unclear, however, whether this new regulatory framework will ultimately benefit requestors. at 1368 (emphasis added). However, OIG’s sentiment may presume too much. First, OIG appears to presuppose that any conduct under investigation by DOJ—by virtue of it being under investigation—is problematic.

Fraud 52

Fraud Governance Compliance Regulatory Compliance 52

Florida Health Care Law Firm

MARCH 9, 2022

A pharmacist should evaluate each prescription, focus on regulatory compliance, and only dispense a prescription written for a legitimate medical purpose and pursuant to a valid prescriber-patient relationship.

Regulatory Compliance 40

Regulatory Compliance Compliance Doctors Fraud 40

Florida Health Care Law Firm

FEBRUARY 22, 2022

He has also had assets forfeited since these assets were acquired with money from his ill-gotten fraud scheme. In yet another take-down of an illicit scheme to defraud the Medicare Program and ChampVA, as well as other insurers, Patsy Truglia has been sentenced to 15 years in federal prison.

Medicare 52

Medicare Medicare Telemedicine Medicaid 52

HIT Consultant

DECEMBER 6, 2022

As within many areas of health care, however, expansion and innovation contributed to a higher risk of fraud and resulted in an increase in enforcement activity. Telemental health providers were not immune to this activity in 2022, and providers should prioritize regulatory compliance as the industry looks ahead to 2023. “As

Compliance 98

Compliance Medicaid Medicaid Telemedicine 98

Health Care Law Brief

NOVEMBER 30, 2021

In an advisory opinion posted November 10, 2021 ( AO 21-15 ), the Office of the Inspector General of the United States Department of Health and Human Services (OIG) appeared to soften a disturbing position that it had taken in 2012 regarding the employment safe harbor.

Medicare 40

Medicare Medicare Regulatory Compliance Fraud 40

Drug & Device Law

MAY 24, 2022

In both New Jersey and Florida, there is a strong presumption against punitive damages in drug and device cases where there’s been regulatory compliance. In response to the summary judgment motions, plaintiff abandoned 11 of those claims including various strict liability, fraud/misrepresentation, and warranty claims.

FDA 52

FDA Regulatory Compliance Compliance Fraud 52