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OIG Plans to Focus on Medicare Part B Payments for Telemedicine

The Department of Health and Human Services Office of Inspector General, (HHS OIG) recently announced a new project designed to review Medicare Part B payments for telemedicine services. It’s part of the OIG’s Work Plan initiatives released last November and updated monthly. Among the June/July updates, the agency noted it will be looking to see […]

Opioid Crackdown Requires Increased Focus on Compliance

It’s not just drug dealers and traffickers selling opioids who have become the target of law enforcement. Earlier this month, the Department of Health and Human Services Office of the Inspector General, along with state and federal law enforcement partners, targeted healthcare providers. The agency announced that 412 defendants including 115 doctors, nurses and other […]

CMS Proposes Changes to 2018 Medicare Fee Schedule

The Centers for Medicare and Medicaid Services (CMS) has issued a proposed rule that will update Medicare payment and policies for doctors and other healthcare providers that the agency says “reflect a broader strategy to relieve regulatory burdens for providers; support the patient-doctor relationship in healthcare; and promote transparency, flexibility, and innovation in the delivery […]

OIG Cracks Down on Hospice Provider Fraud

Last year, the HHS Office of the Inspector General stated the hospice fraud was rampant and that it would be an enforcement priority for the agency. The OIG found that some hospice operators, doctors and staff were recruiting patients to maximize profits, even when in some cases the patients didn’t need hospice care. Their illegal […]

June a busy month for healthcare fraud enforcement

Individual physicians, medical billers, DME manufacturers, healthcare executives and even entire healthcare systems were on the receiving end of the U.S. Department of Health and Human Services Office of the Inspector General’s (OIG) enforcement efforts last month. In fact, there were 39 actions announced by the IG’s office in June, up from 35 in May […]

New Florida Law Cracks Down on Patient Brokering by Drug Treatment Providers

Effective July 1, drug treatment providers in Florida must comply with stringent new regulations designed to crackdown on corruption within the industry. Late last month, Governor Rick Scott signed into law HB 807, commonly referred to as the “Practices of Substance Abuse Service Providers Act.” The new law provides state regulators with broader powers as […]

Genesis Healthcare Settlement Another Example of Government’s Anti-Fraud Campaign

Whatever else is taking place in the nation’s capital these days, one thing is for certain, there is no letup in the government’s crackdown on healthcare fraud. This is made clear by the continued announcements of multimillion-dollar settlements coming from various fraud-fighting agencies. One of the more recent settlements involves Genesis Healthcare, Inc., a Kennett […]

OIG: CMS Overpaid Providers Millions in EHR Incentive Payments

The Department of Health and Human Services’ Office of Inspector General (OIG) recently released a report finding that the Centers for Medicare & Medicaid Services (CMS) overpaid some $729 million in Medicare electronic health record (EHR) incentive payments to eligible providers who did not comply with federal meaningful use requirements. In its report, the OIG […]

OCR Provides Update on HIPAA Enforcement Efforts

The recent WannaCry ransomware attack impacting hospital and healthcare information systems worldwide shone a bright light on the vulnerabilities of most healthcare provider’s networks. But the problem extends far beyond this one case. In fact, there are near daily reports of patients’ private information being accessed due to a lack of appropriate security measures. And, […]

Billing Medicare for Free Samples Can Land Healthcare Providers in Hot Water

It’s not unusual for physicians to receive free samples to give to their patients. But billing the federal government for them is a definite no-no as one St. Louis, Missouri neurologist recently learned. According to a recent news release from the U.S. Department of Justice, Dr. Sherry X. Ma and her clinic, AIMA Neurology, LLC, […]