CMS Looks to Streamline Self-Disclosure Process

In an attempt to streamline the self-disclosure process, The Centers for Medicare and Medicaid Services (CMS) recently posted revisions to the Voluntary Self-Disclosure Protocol (SRDP), which allows providers of healthcare services and suppliers to self-disclose actual or potential violations of the federal physician self-referral law. Beginning June 1, providers of services and suppliers must use […]

OIG’s New Safe Harbors, Civil Monetary Penalty Exceptions Set to Take Effect

On January 6, new safe harbors to the federal anti-kickback statute and amendments to the civil monetary penalty rules will take effect. The expansion of existing safe harbors, along with the addition of new ones, were issued by the Department of Health and Human Services Office of the Inspector General on Dec. 7, and are […]

CMS looks to formalize six-year lookback period for Medicare self-referral disclosures

The Centers for Medicare and Medicaid recently published a notice proposing revisions to its self-referral disclosure protocol (SRDP). The SRDP allows healthcare providers and suppliers to self-disclose actual or potential violations of the physician self-referral statute, or Stark Law. Under the proposal, healthcare providers who use the SRDP will have to provide the agency with […]

Healthcare Fraud and Abuse Crackdown Not Slowing as Evidenced by Recent Cases

The federal government has been busy since the beginning of the year announcing arrests, convictions and settlements relating to healthcare fraud and abuse. The activities relate to violations of the Stark Law, anti-kickback law and federal False Claims Act, and there appears to be no end in sight. Whether it’s home health, transportation, durable medical […]

How whistleblowers are helping to fight healthcare fraud

Earlier this month, the Department of Justice announced it had resolved a $237 million judgment against Toumey Healthcare System in South Carolina for violations of the Stark Law. In this particular case, the hospital was alleged to have entered into contracts with 19 specialists that required them to refer their outpatient procedures to the hospital […]

Compounding pharmacies in the eye of investigative storm

In the last year or so there have been a number of stories in the media about investigations into wrongdoing by compounding pharmacies, marketing companies and physicians. At last count there were nearly 100 federal investigations underway for what the feds believe are questionable financial relationships involving these three entities. In some instances, physicians are […]