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OIG Opinion Applies Access to Care Exception

Can a hospital system provide free or reduced-cost lodging and meals to certain financially needy patients, or would such an arrangement (a) constitute either a violation of the federal anti-kickback statute or (b) constitute grounds for the imposition of civil monetary penalties because it would violate a provision of the Social Security Act that prohibits […]

Moving from SSN to MBI: The time to prepare is now

In just about a year from now the Centers for Medicare & Medicaid Services (CMS) will start mailing out new Medicare cards to beneficiaries that will eliminate the use of Social Security Numbers, replacing them with Medicare Beneficiary Identifiers (MBI). This change is pursuant to the 2015 passage of the Medicare Access and CHIP Reauthorization […]

Backlog backlash: HHS says clearing Medicare backlog not possible

Just two months after a federal judge told the Department of Health and Human Services (HHS) to clear through a huge backlog of Medicare claims appeals comes word from the agency that not only will it not be able to comply, but that the backlog will actually grow by the time it’s supposed to have […]

New Corporate Compliance Guidance Issued by DOJ

If you had any doubt that the U.S. Department of Justice had plans to back off its crackdown on healthcare fraud under then new Trump administration, all you need to do is look at its recently released guidance on corporate compliance to understand that it will continue to keep the pressure on. Titled Evaluation of […]

HIPAA Data Breach Deadline Fast Approaching

Last week, we wrote about the increasing number of healthcare-related data breaches and how important it is for providers to find better ways to protect their patients’ personal healthcare information. In just a few days – on March 1 – HIPAA-covered entities must submit reports of certain breaches of unsecured protected health information affecting fewer […]

HIPAA Compliance in 2017: The Heat is on

The doctor-patient relationship has always involved a certain level of privacy. But over the years, the stakes for healthcare providers who violate patient privacy have increased exponentially. Barely two months into 2017 and already we are seeing increased activity. A newly released report from Protenus in conjunction with databreaches.net, January saw 31 healthcare data breaches […]

Case of 79-year-old doctor illustrates need for caution when accepting payments

The federal trial of a 79-year-old New Jersey physician charged in connection with a healthcare kickback scheme serves as yet another example of federal prosecutors’ aggressive stance against healthcare fraud and abuse. Dr. Bernard Greenspan is the latest physician to find himself facing jail time. He was among more than 40 people, many of them […]

New Rule Makes it Easier to Share Substance Abuse Information While Protecting Privacy

The U.S. Department of Health and Human Services recently finalized changes to federal regulations relating to the confidentiality of substance-use disorder patient records. Published in the Federal Register on January 18, the rule makes it easier to share the medical history of patients undergoing substance abuse treatment in federally funded drug and alcohol treatment programs, […]

New exclusion rules to take effect next month

Earlier this month, the Health and Human Services Office of the Inspector General (HHS-OIG) finalized its long-awaited rules on civil monetary penalties that could make it easier for providers to be excluded from participating in the Medicare and Medicaid programs. The final rule, which was published in the Federal Register on January 12, was first […]

CMS issues sweeping new rules for HHA participation in Medicare/Medicaid

Home health agencies have six months to comply with sweeping new changes that will impact their ability to participate in the Medicare and Medicaid programs. Earlier this month, The Centers for Medicare and Medicaid, released its final rules relating to the conditions of participation (CoPs) that home health agencies must meet to participate in the […]