William Mathias

William Mathias

Ober|Kaler

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OIG Approves Subsidies to Medicare Beneficiaries Provided by a Clinical Research Study

On May 28, 2015, the U.S. Department of Health & Human Services, Office of Inspector General (OIG) issued an advisory opinion approving a medical device manufacturer’s proposed arrangement to provide subsidies to certain...more

6/23/2015 - Advisory Opinions Anti-Kickback Statute Civil Monetary Penalty Clinical Trials Device Manufacturers HHS Medical Devices Medicare OIG Subsidies

Medigap Insurer's Contract with Preferred Hospital Network Approved (Yet Again)

On April 22, 2015, the Department of Health and Human Services, Office of Inspector General (OIG) issued Advisory Opinion 15-05 [PDF], approving a Medigap insurer’s proposed contract with a preferred hospital network. The...more

5/9/2015 - CMP Law Health Insurance HHS Hospital Networks Medicare Medigap OIG PPOs

Medicare Proposes Prior Authorization Process for Certain DMEPOS Items

On May 28, 2014, CMS issued a proposed rule to establish a permanent prior authorization process for certain durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) items that are “frequently subject to...more

6/9/2014 - CMS DMEPOS Enforcement Healthcare Medicare Prior Authorization Proposed Regulation

OIG Proposes Updates to Exclusion and CMP Authority

The Department of Health and Human Services, Office of Inspector General (OIG) recently issued a pair of proposed regulations to update its exclusion and civil monetary penalty (CMP) authority. The proposed regulations...more

6/3/2014 - Affordable Care Act Civil Monetary Penalty CMS Compliance Exclusions Healthcare Healthcare Reform HHS Medicaid Medicare OIG

OIG Supplemental Special Advisory Bulletin Raises New Concerns About Independent Charity Patient Assistance Programs

In an effort to address new concerns about the independence of charity patient assistance programs (PAPs), the Office of Inspector General (OIG) released its Supplemental Special Advisory Bulletin: Independent Charity Patient...more

5/30/2014 - Anti-Kickback Statute Healthcare Medicare Medicare Part D OIG Patient Assistance Programs Pharmaceutical

Chance to Comment on Future of DMEPOS Payments

CMS recently took the unusual step of issuing an Advance Notice of Proposed Rulemaking (ANPR) regarding changes to Medicare payment methodologies for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS)...more

3/26/2014 - Affordable Care Act CMS Competitive Bidding Durable Medical Equipment Healthcare Medical Devices Medicare

Program Integrity Priorities Revealed in FY 2015 HHS Budget

On March 14, 2014, President Obama unveiled his Administration’s proposed fiscal year 2015 budget for the Department of Health and Human Services (HHS). In total, the Administration is seeking $77.1 billion to fund HHS in FY...more

3/14/2014 - Affordable Care Act CMS Federal Budget Healthcare Fraud Healthcare Reform HHS Medicare Physician Medicare Reimbursements Stark Law

OIG Advisory Opinions Provide Some Helpful Guidance

In spite of a slow start, the OIG has issued a number of interesting advisory opinions to date in 2013. Here are a few of the highlights. The OIG reiterated its long-standing concern about arrangements which “carve out”...more

7/19/2013 - Advisory Opinions Health Insurance Healthcare Hospitals Medicare Medigap OIG

2013 Healthcare Fraud and Abuse Bootcamp Webinar Series, Part V: Compliance

Bill Mathias of Ober|Kaler's Health Law Group presented on compliance as a part of the 2013 Healthcare Fraud and Abuse Bootcamp Webinar Series sponsored by the American Health Lawyers Association. This webinar...more

6/17/2013 - Anti-Kickback Statute Audits CMS Compliance Documentation False Claims Act Healthcare Fraud Internal Investigations Medicaid Medicare OIG Penalties Self-Disclosure Requirements Stark Law

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