On February 1, 2022, the United States Department of Justice (DOJ) announced that it had recovered $5.6 billion from False Claims Act (FCA) Cases during fiscal year 2021. Each year, the DOJ publishes statistics about its...more
On February 22, 2021, the United States Supreme Court declined to review two False Claims Act (FCA) cases, solidifying a split that pits the Eleventh Circuit against the Third and Ninth Circuits as to whether a disagreement...more
On January 14, 2021, the United States Department of Justice (DOJ) announced that it had recovered $2.2 billion from False Claim Act (FCA) Cases during 2020. Each year, the DOJ publishes statistics about its recoveries under...more
On November 20, 2020, the Department of Health and Human Services (HHS), Office of Inspector General (OIG), and the Centers for Medicare and Medicaid Services (CMS) finalized three rules making historic changes to three of...more
In a Special Fraud Alert issued on November 16, 2020, the Department of Health and Human Services Office of Inspector General (HHS-OIG) raised significant fraud and abuse concerns with companies offering or providing...more
On October 31, 2019, the Office of General Counsel for the U.S. Department of Health and Human Services (HHS) issued an important memo from Kelly M. Cleary, CMS Chief Legal Officer, and Brenna E. Jenny, Deputy General...more
12/5/2019
/ Administrative Procedure Act ,
Azar v Allina Health Services ,
Centers for Medicare & Medicaid Services (CMS) ,
Denial of Benefits ,
Department of Health and Human Services (HHS) ,
False Claims Act (FCA) ,
Health Care Providers ,
Hospitals ,
Local Coverage Determination (LCD) ,
Low-Income Issues ,
Medicare ,
Medicare Advantage ,
Medicare Part A ,
Medicare Part C ,
Notice and Comment ,
Overpayment ,
Pay Reductions ,
Provider Payments ,
Reaffirmation ,
Retroactive Application ,
Rulemaking Process ,
SCOTUS ,
Substantive Rule ,
Universal Health Services Inc v United States ex rel Escobar ,
Vacated
Every day, people rely on highly skilled professionals to recall from memory a litany of information which helps them assess conditions, use their judgment, and respond accordingly. It should come as no surprise then, that...more
A federal court has ordered discovery regarding the circumstances of a Medicare payment suspension by CMS only one week after failed settlement negotiations between a cardiology practice and the Department of Justice (DOJ) to...more
6/16/2015
/ Centers for Medicare & Medicaid Services (CMS) ,
Department of Justice (DOJ) ,
Discovery ,
False Claims Act (FCA) ,
Fraud ,
Health Care Providers ,
Healthcare ,
Medicaid ,
Medicare ,
Preliminary Injunctions ,
Provider Payments ,
Retaliation ,
Suspensions
In This Issue:
- Top News
..Congress Approves Budget Deal with Short-Term ‘Doc Fix'
..CMS “Two-Midnight” Rule delayed until March 31, 2014
..Individuals with Canceled Insurance Policies May Apply for...more
1/24/2014
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
EHR ,
Exempt Organizations ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare ,
Healthcare Fraud ,
Healthcare Reform ,
Hospitals ,
Medicare ,
Misbranding ,
OCR ,
OIG ,
Prescription Drugs ,
Tax Exemptions
In This Issue:
- Exclusion from Federal Health Care Programs
- The New Advisory Bulletin
- What Providers Should Know
- For More Information
- Excerpt from Exclusion from Federal Health Care...more