Archive for May 2016
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…
Read MoreAudit: HHS fails to accurately report and prevent improper payments
A recent audit of the Department of Health and Human Services (HHS) to determine if the agency is in compliance with the reporting standards required under the Improper Payments Information Act (IPIA) of 2002 found an ongoing failure by the agency to accurately report and prevent improper payments. The audit, conducted by Ernst & Young…
Read MoreHIPAA Compliance Crackdown Requires Increased Vigilance
Last month, the U.S. Department of Health and Human Services Office for Civil Rights (OCR) announced two big settlements involving alleged violations of the Health Insurance Portability and Accountability Act (HIPAA). Those cases brought to six the number of HIPAA-related cases settled since the start of 2016. It also underscores the need for healthcare providers…
Read MoreCMS unveils new Medicare payment proposal
On April 27, The Centers for Medicare and Medicaid (CMS) released, for public comment, proposed changes to how Medicare will pay providers. The proposed rule for the Medicare Access and CHIP Reauthorization Act (MACRA), enacted a year ago by Congress, eliminates the Sustainable Growth Rate (SGR) formula for setting reimbursement rates and simplifies many of…
Read MoreSCOTUS Hears Arguments on Implied Certification Theory
Last month, the United States Supreme Court took up the issue of whether False Claims Act (FCA) cases may be brought by whistleblowers and the government under the theory known as “implied certification.†And, if so, under what circumstances. On April 19, the high court heard oral arguments in Universal Health Services v. United States…
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