Topic
Fraud & Abuse
129 published works
Administrative and Regulatory
Recent Settlements May Indicate Increased Government Focus on the Stark Law’s “Group Practice” Requirements and Exception for “In-Office Ancillary Services”
By Victoria Vaskov Sheridan, Gary W. Herschman, Joseph E. Lynch
Recent settlement agreements between the United States Department of Justice (the “DOJ”) and two urologist business partners suggests that the government may be focusing increased enforcement efforts on the Stark…
Health Industry Washington Watch
VA and HHS Team Together to Combat Health Care Fraud, Waste, and Abuse
The Department of Veterans Affairs (VA) and the Centers for Medicare & Medicaid Services (CMS) have announced a partnership to leverage CMS’s program integrity tools to detect and prevent fraud…
Health Law Diagnosis
CMS Issues Temporary Enrollment Moratorium on Home Health Agencies and Non-Emergency Ambulances in Selected States
By Robinson+Cole's Health Law Group
On January 29, 2017, the Centers for Medicare and Medicaid Services (CMS) announced a temporary moratorium on enrolling Part B non-emergency ambulance providers/suppliers and home health agencies, subunits and branch…
Health Industry Washington Watch
CMS Again Extends HHA/Ambulance Enrollment Moratoria in Selected States to “Prevent and Combat Fraud, Waste, and Abuse”
The Centers for Medicare & Medicaid Services (CMS) has once again extended for six months its “temporary” moratoria on the Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) enrollment of…
Employee Benefits Blog
OIG Reports More than $731 Million in Inappropriate Medicare Meaningful Use Payments
By Amanda Enyeart, Lisa Schmitz Mazur
Amanda Enyeart and Lisa Schmitz Mazur wrote this bylined article explaining how the HHS Office of Inspector General used a survey by the Electronic Health Records (EHR) Incentive Program run…
Inside Business Immigration
Agencies Open H-1B Cap Season with Initiatives to Combat Fraud and Abuse
The U.S. immigration agency’s busiest day of the year was marked with reminders about the dark side of the H-1B visa program. Acceptance of H-1B cap-subject petitions started on April…
Health Law Update
Former Tuomey CEO Settles with DOJ for $1 Million
By Donna S. Clark, Banee Pachuca
The U.S. Department of Justice (DOJ) recently reached a $1 million settlement with Ralph J. Cox III, the former CEO for Tuomey Health System, Inc. (Tuomey), in connection with his…
FCA Update
Old Dog, New Tricks: Fraud and Abuse in the Age of Payment Reform
By Daniel H. Melvin, Monica Wallace
The good, reassuring news about that “old dog” fraud and abuse as it enters an age of payment reform is that criminal liability for fraud still requires a specific intent…
Health Law Update
Summer Fraud and Abuse Roundup
By Banee Pachuca, David S. Allen
Now that the kids are back in school and summer vacations are in the rearview mirror, it’s time to catch up on recent fraud and abuse developments. The federal government…
Health Law
Medicaid Managed Care Final Rule: Prevention of Fraud, Waste, and Abuse
By Roma Sharma
The Medicaid Managed Care Final Rule aims to align Medicaid regulations with those of other health coverage programs, modernizing the post-Affordable Care Act healthcare landscape. Among other goals, the Final…