Insurance

Read Science, Computers & Technology updates, news, alerts, and legal analysis from leading lawyers and law firms:

News & Analysis as of May 20, 2013

PODs Beware: OIG Releases Special Fraud Alert

by Matthew Murer | Polsinelli on 5/10/2013

The Office of the Inspector General (OIG) released a Special Fraud Alert on March 26, 2013 warning that physician-owned distributorships (PODs) are "inherently suspect" under the Anti-Kickback Statute (AKS). Generally...more

OIG Unveils Updated Self-Disclosure Protocol

by George Breen, Jason Christ, Anjali Downs, Jennifer Goodwin, David Matyas, Deepa Selvam, Carrie Valiant | Epstein Becker & Green, P.C. on 4/23/2013

In 1998, the Department of Health and Human Services' Office of Inspector General ("OIG") published the Self-Disclosure Protocol ("SDP"), which provides a mechanism through which health care providers may voluntarily report...more

OIG Updates Provider Self-Disclosure Protocol

by B. Scott McBride, Summer Swallow | BakerHostetler on 4/19/2013

On April 17, 2013, the U.S. Department of Health and Human Services Office of Inspector General (OIG) published a revised Provider Self-Disclosure Protocol (SDP) that clarifies the process for healthcare providers, suppliers...more

340B Drug Pricing Program: Recent Developments

by Elizabeth Elson, Anil Shankar | Foley & Lardner LLP on 4/19/2013

The 340B Drug Pricing Program (340B Program) continues to undergo a period of intense scrutiny and debate over how compliance with program rules is enforced. As previously reported in the May 30, 2012 edition of Foley’s Legal...more

CMS to Deny Claims When Ordering/Referring Provider Not Enrolled in Medicare

by Joan Polacheck, Monica Wallace | McDermott Will & Emery on 3/20/2013

Effective May 1, 2013, the Centers for Medicare & Medicaid Services (CMS) will begin to deny Part B Durable Medical Equipment (DME) and Part A Home Health Agency (HHA) claims for services or supplies when the...more

Big Changes Are Happening With the 340B Drug Program

by Ellyn L. Sternfield | Mintz Levin - Health Law on 3/6/2013

Things are drastically changing for covered entities under the 340B program. In the last 18 months several factors have led the Health Resources and Services Administration (HRSA) to ramp up its oversight and auditing of...more

Are Compliance Officers Getting Paid Their Worth?

by NAVEX Global on 2/27/2013

The NAVEX Global-sponsored 2012 SCCE (Ethics & Compliance Industry) Salary Survey was released this week (download report). In the executive summary, SCCE CEO Roy Snell highlights the necessity that the broader industry has...more

Health Care Enforcement in 2012: A Year in Review

by Hope Foster, Samantha Kingsbury, Tracy Miner, Jessica Sergi, Stephanie Willis | Mintz Levin - Health Law on 2/26/2013

Last year was another busy year in health care fraud enforcement. In 2012, the Office of Inspector General for the Department of Health and Human Services (HHS-OIG) reported total expected recoveries of $6.9 billion from all...more

10 Fraud and Abuse Enforcement Trends You Can't Afford to Ignore in 2013

by Cory Fox, Gregory Saikin | BakerHostetler on 2/15/2013

To paraphrase a famous quote, "Those who do not learn from history are doomed to repeat it," and providers who ignore the significance of the federal government's healthcare fraud enforcements efforts in 2012 do so at their...more

Health Reform + Related Health Policy News Update - February 6, 2013

by Colleen M. Faddick, Bruce A. Johnson, Matthew Murer, Alan K. Parver | Polsinelli on 2/7/2013

In This Issue: - Top News ..CMS Announces Round 2 Competitive Bidding Single Payment Amounts ..CBO Lowers SGR Repeal Cost by $100 Billion ..Republicans Press HRSA on 340B Audits ..HHS Proposes...more