The Centers for Medicare and Medicaid Services (CMS) published the final rule outlining how civil monetary penalties will be calculated and imposed when Responsible Reporting Entities (RRE) fail to meet their Medicare...more
On August 13, the D.C. Circuit revived the CMS 2014 Medicare Advantage Overpayment Rule in deciding UnitedHealthcare Ins. Co. v. Becerra, a ruling that could have broad implications for Medicare Advantage (MA) insurers. See...more
Can a pharmaceutical manufacturer provide free items or services to financially needy Medicare and Medicaid beneficiaries without running afoul of the Beneficiary Inducements Civil Monetary Penalty (CMP) or the Anti-Kickback...more
2/11/2019
/ Advisory Opinions ,
Anti-Kickback Statute ,
Beneficiary Inducement ,
Digital Health ,
Low-Income Issues ,
Medicaid ,
Medical Devices ,
Medicare ,
OIG ,
Patient Assistance Programs ,
Pharmaceutical Industry
The Work Plan describes more than 100 initiatives, including 43 new initiatives for the upcoming year.
On November 2, the Department of Health and Human Services (HHS) Office of the Inspector General (OIG) issued its...more
The Centers for Medicare and Medicaid Services (CMS) recently made several announcements regarding Medicare, Medicaid, and SCHIP Extension Act (MMSEA) Section 111 reporting for Non-Group Health Plans (NGHPs).
Originally...more
The update to the Fiscal Year 2015 Annual Work Plan includes new initiatives that may affect pharmaceutical companies and Medicare Part D payors and pharmacies.
Annually, the Department of Health and Human Services...more
6/15/2015
/ Department of Health and Human Services (HHS) ,
Healthcare ,
Medicaid ,
Medicaid Reimbursements ,
Medicare ,
Medicare Part D ,
OIG ,
Payor Contracts ,
Pharmaceutical Industry ,
Pharmacies ,
Reporting Requirements