Affordable Care Act, Medicare, Healthcare Fraud

Is Your Employee or Contractor Excluded?

Quarles & Brady LLP on 6/10/2024

Employers must check its employees, contractors and vendors to see if an individual or organization is excluded from participating in federal and/or state programs. While there are a variety of exclusion programs at the...more

Medtronic Settles Kickback And Open Payments Violations For $9.2M

Rivkin Radler LLP on 11/13/2020

The U.S. Department of Justice (DOJ) announced on October 29 that Medtronic USA Inc. agreed to pay $8.1 million to settle allegations that it violated the False Claims Act (FCA) and federal Anti-Kickback Statute by paying...more

Waste, fraud, and abuse? For health insurers, fat profits matter more

Patrick Malone & Associates P.C. | DC Injury... on 7/26/2019

What happens when a whistle blower provides detailed information about a burly Texan — with convictions for felony theft and felony injury of a child — and a burgeoning scam to rip off health insurers for $25 million? Pretty...more

In Significant Shift, DOJ Takes Position that Affordable Care Act Is Unconstitutional

King & Spalding on 4/5/2019

On Monday, March 25, 2019, the Department of Justice (DOJ) endorsed the decision of a district court judge in the Northern District of Texas that invalidated the entire Affordable Care Act (ACA) as unconstitutional. Texas v....more

Healthcare Law Update: May 2018

Holland & Knight LLP on 5/30/2018

Enforcement - OIG Issues Advisory Opinion on Provision of Samples by a Device Distributor - On April 30, 2018, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) issued a...more

Healthcare Fraud & Abuse Review 2017

Bass, Berry & Sims PLC on 3/13/2018

A LOOK BACK... A LOOK AHEAD - While the uncertainty associated with legislative efforts to repeal the Patient Protection and Affordable Care Act (PPACA) dominated most of the headlines for the healthcare industry last year,...more

Trump Administration Fiscal Year (FY) 2019 Budget and Healthcare Programs

Holland & Knight LLP on 2/19/2018

The Trump Administration on Feb. 12 released its Fiscal Year (FY) 2019 budget request, titled "An American Budget." Unlike last year's budget, which was released in late May, the release of this budget conforms to the typical...more

"Republicans Chart New Course for US Health Care System"

Skadden, Arps, Slate, Meagher & Flom LLP on 2/4/2017

While President Donald Trump made repeal of the Affordable Care Act (ACA) a centerpiece of his 2016 presidential campaign, he offered few details about how he would replace it or address other health care issues. More...more

2016 Health Care Year in Review

Burr & Forman on 12/12/2016

Since I began writing this year-end review in 2013, there have been some common themes – a shift to pay for quality and away from fee-for service, much of which has been brought about by the Affordable Care Act (ACA): efforts...more

OIG laments failure to comprehensively address EHR fraud

Robinson+Cole Data Privacy + Security Insider on 4/19/2016

The U.S. Department of Health & Human Services (HHS) Office of Inspector General (OIG) recently released a compendium (Compendium) of its top unimplemented recommendations. The Compendium comprises 25 unimplemented past OIG...more

The Medicare Overpayment Rule: Implications for Compliance and Health Care Enforcement

Mintz - Health Care Viewpoints on 3/2/2016

As has been widely discussed, the Centers for Medicare & Medicaid Services (‘‘CMS’’) Feb. 12 published the long-awaited final rule governing the return of Medicare Part A and Part B overpayments within 60 days (the...more

A&B Healthcare Week in Review

Alston & Bird on 2/26/2016

I. REGULATIONS, NOTICES, & GUIDANCE - On February 24, 2016, the Centers for Medicare & Medicaid Services (CMS) issued a guidance entitled, “Special Enrollment Confirmation Process” that will enhance program integrity...more

2015 Health Care Year in Review

Burr & Forman on 12/17/2015

In 2015, ICD-10 finally became a reality, and the dire predictions of problems seem to be wrong. Providers now have codes to describe just about every conceivable (and a few simply bizarre) medical occurrences. If a patient...more

Washington Healthcare Update

McGuireWoods LLP on 7/21/2015

This Week: Senate Reauthorizes Older Americans Act; Bill Heads to the House... White House Holds 2015 Conference on Aging and Launches Several New Administration Healthy Aging Initiatives Enveloping Alzheimer’s, Dementia,...more

Washington Healthcare Update

McGuireWoods LLP on 6/23/2015

This Week: Leading Up to the SCOTUS King v. Burwell Decision... House Votes to Repeal the Medical Device Tax... CMS Announces It Will Bolster Transitional Reinsurance Payments... MedPAC Releases June Report to Congress....more

Washington Healthcare Update

McGuireWoods LLP on 6/9/2015

This Week: House Ways & Means Committee Holds Markup; Makes Significant Legislative Changes to Health Care Bills... Senate Finance Committee Holds Markup on Medicare Appeals Process Bill... CMS Issues Final Rule on...more

Physicians as whistleblowers: Doctors get rich by exposing fraud

McAfee & Taft on 5/22/2015

As the federal and state governments have evolved from Uncle Sam to Doctor Sam, the potential for healthcare waste, fraud and abuse has also increased. One way the government has deterred healthcare fraud is by enacting and...more

Washington Healthcare Update

McGuireWoods LLP on 3/31/2015

This Week: House Approves FY 2016 Budget Proposal... House Passes Permanent SGR Reform and Two-Year CHIP Reauthorization... Senate Passes FY 2016 Budget Plan... HHS Report: ACA Led to $7.4 Billion Decline in Uncompensated...more

Health Care Update - March 2015 #4

Mintz - ML Strategies on 3/30/2015

In This Issue: - Permanent Medicare Doc-Fix Entering Critical Week - Implementation of the Affordable Care Act - Other Federal Regulatory Initiatives - Congressional Initiatives - Other...more

Is Health Care Fraud on the Rise? Or Just the Accusations??

Williams Mullen on 3/26/2015

Recent stories in the news seem to suggest that health care fraud is running rampant. We’ve got stories about Eric Leak‘s Medicaid agency, Nature’s Reflections, funneling money to pay athletes, a seizure of property in...more

New CMS Enrollment Rules Strengthen Oversight of Medicare Providers

King & Spalding on 12/10/2014

On December 5, 2014, CMS published a final rule to strengthen its oversight of Medicare providers. The rule includes safeguards designed to prevent providers with unpaid debt from re-entering Medicare and to remove providers...more

News from the Health Law Gurus™: Week of May 11th, 2014

Obermayer Rebmann Maxwell & Hippel LLP on 5/19/2014

News from the Health Law Gurus™ is a weekly summary of notable health law news from around the country with helpful links to related content. ...more

Program Integrity Priorities Revealed in FY 2015 HHS Budget

Baker Donelson on 3/14/2014

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

Health Reform + Related Health Policy News - January 2014, Issue 1

Polsinelli on 1/24/2014

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

False Claims Act Whistleblower Bounties Exceed $345 Million in Fiscal Year 2013

Sheppard Mullin Richter & Hampton LLP on 1/23/2014

The DOJ has released its Fiscal Year (“FY”) 2013 totals for civil settlements and judgments recovered under the federal False Claims Act (“FCA”). To say that the Department had a successful year in prosecuting fraud against...more

Patient Protection and Affordable Care Act (PPACA) › Medicare › Healthcare Fraud

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