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Archive for September 2017

CMS Issues Guidance on When a Hospital is a Hospital

By The Health Law Offices of Anthony C. Vitale | September 25, 2017

Is your hospital really a hospital? Well, that depends on whether Medicare deems it so. Earlier this month, the Centers for Medicare & Medicaid Services issued clarifying guidance on what constitutes a hospital. Under these new guidelines, holding a state hospital license isn’t necessarily the end-all for receiving Medicare reimbursement. CMS says it will now…

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Joint Commission Issues Alert on Hand-off Communication

By The Health Law Offices of Anthony C. Vitale | September 18, 2017

“What we have here is a failure to communicate” is a line from the 1967 film Cool Hand Luke. It’s also a problem in the world of healthcare when one provider hands over a patient’s care to another for continued care and treatment. Earlier this month, the Joint Commission issued a new Sentinel Event Alert…

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The FCA and the Use of Statistical Sampling

By The Health Law Offices of Anthony C. Vitale | September 11, 2017

The U.S. Department of Justice late last month agreed to a $275,000 settlement in a False Claims Act case against a South Carolina-based company that operates elder care facilities. What’s significant about this case is that two years earlier, the DOJ rejected a significantly higher – $2.5 million – settlement. In the initial case, United…

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New vs. Established Patient Billing: Are You Doing It Properly?

By The Health Law Offices of Anthony C. Vitale | September 5, 2017

It’s no secret that the Department of Health and Human Services Office of the Inspector General (HHS OIG) has been scrutinizing how Medicare pays providers for new and established patients. Such scrutiny has resulted in providers having to pay back millions for incorrectly billing for a new patient visit when the visit should have been…

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Recent Posts

  • Florida Man Gets 14 Years in Genetic Testing Fraud Scheme
  • Watchdog Agency Details Enforcement Activities During Six-Month Period
  • Billing Under Another’s Credentials Results in FCA Violation for Therapy Company
  • Six MDs Added to Laboratory Civil False Claims Case Filed in April
  • Pharmacy Owner, Others Sentenced in $174M Telemedicine Pharmacy Fraud Scheme

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