Topic
Fraud & Abuse
129 published works
Health Care Law Matters
Fraud and Abuse Compliance More Important Than Ever
Health care fraud and abuse enforcement activity is at an all-time high yet many physicians and other providers lack a basic understanding of the key healthcare fraud and abuse statutes…
Health Industry Washington Watch
GAO Report on Impact of Fraud and Abuse Laws on Medicare Financial Incentive Programs
A recent GAO report focuses on how federal fraud and abuse laws affect the implementation of financial incentive programs intended to improve quality and efficiency, such as pay-for-performance programs that…
CommLawBlog
FCC Tightens up Lifeline Program
By FHH Law
Looking to rein in fraud, waste, and abuse in the federal Lifeline program, the FCC has pulled out almost every bureaucratic tool in the box.
Health Industry Washington Watch
CMS Announces New Start Date for Recovery Audit Prepayment Review, Power Mobility Device Demonstrations
In November 2011, CMS announced plans to conduct three new demonstrations in 2012 designed to combat Medicare fraud, waste, and abuse. While one of the demonstrations, a Part A to Part…
Health Industry Washington Watch
Justice Department FCA Recoveries Top $3 Billion in FY 2011
The Department of Justice (DOJ) has announced more than $3 billion in False Claims Act (FCA) recoveries in FY 2011, including $2.4 billion in recoveries involving federal health care program fraud. The…
Health Care and Life Sciences
Medicare Providers and Suppliers Continue in the Spotlight: Medicare Providers and Suppliers Continue in the Spotlight
By George B. Breen, Amy Lerman, Emily Bajcsi
Expansion of the DMEPOS Competitive Bidding Program; Legislative Inquiry Related to Fraud and Abuse Enforcement Actions; and Automated Pre-Enrollment Provider Screening by George B. Breen, Amy F. Lerman, Emily E.…
Health Industry Washington Watch
New CMS Demonstration Programs Target Medicare Improper Payments
CMS is conducting three new demonstrations in 2012 designed to combat Medicare fraud, waste, and abuse. The first demonstration, the Recovery Audit Prepayment Review, will expand the use of Medicare…
Cam Law
OIG Unfavorably Reviews a Laboratory Management Company’s Proposed Provision of Allergy Testing and Related Services in Exchange for a Percentage of Gross Collections
A new OIG fraud and abuse Advisory Opinion sheds makes percentage-based MSO arrangements questionable, where Medicare is involved. In Advisory Opinion 11-17, the Office of Inspector General ("OIG") of the…
Health Care Law Matters
HHS Office of Inspector General Releases Priorities for Fiscal Year 2012
By David Restaino The Department of Health and Human Services’ (HHS) Office of Inspector General (OIG) has been busy combating fraud and abuse over the last few years – the…
Health Care Law Matters
Another Proposed Physician Joint Venture Bites the Dust
Physicians are feeling the economic burn of the down economy perhaps more than the average American. Not surprisingly, creative physician joint ventures are proliferating in the healthcare industry as a…