News & Analysis as of

Audits Medicare Healthcare Fraud

Health Care Compliance Association (HCCA)

[Event] 2024 Managed Care Compliance Conference - January 29th - 30th, Coronado, CA

Explore the unique issues that are pertinent to managed care professionals! This annual event dedicated to compliance management for health plan providers is returning to an in-person format for 2024. Join your peers and...more

Health Care Compliance Association (HCCA)

[Virtual Event] 2023 Managed Care Compliance Conference - January 31st - February 2nd, 8:25 am - 3:15 pm CT

Join us for our annual event dedicated to compliance management for health plan providers. Learn the latest best practices and emerging trends from industry leaders while making connections with peers and mentors who...more

Health Care Compliance Association (HCCA)

[Event] Regional Healthcare Compliance Conference - July 22nd, Seattle, WA

Looking for compliance training and networking in your area? HCCA’s Regional Healthcare Compliance Conferences offer practitioners convenient, local compliance training, including updates on the latest news in regulatory...more

Health Care Compliance Association (HCCA)

[Virtual Event] 2022 Managed Care Compliance Conference - February 8th - 9th, 8:25 am - 3:45 pm CST

Can’t attend the conference in-person? The virtual Managed Care Compliance Conference, February 8–9, allows you to hear from industry professionals just like you—all from the comfort of your home or office. Geared towards...more

Health Care Compliance Association (HCCA)

[Event] Scottsdale Regional Healthcare Compliance Conference - November 5th, Scottsdale, AZ

Our one-day Regional Compliance Conferences provide attendees with a forum to interact with local compliance professionals, share information about your compliance successes and challenges, and create educational...more

Health Care Compliance Association (HCCA)

[Event] 2022 Managed Care Compliance Conference - January 30th - February 1st, Phoenix, AZ

Attend our annual event for those who manage compliance at health plan providers. Explore topics and issues that are pertinent to industry professionals like you. Learn the latest practices, share strategies, and connect with...more

Oberheiden P.C.

Seven Points to be Aware of for Durable Medical Equipment Company Compliance

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Durable medical equipment (DME) is particularly important for many Medicare beneficiaries. However, companies that manufacture and sell DME need to be careful because there are strict federal regulations outlining almost...more

King & Spalding

OIG Releases Semiannual Report to Congress

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On May 28, 2021, OIG released its Semiannual Report to Congress (the Report). The Report describes OIG’s work during the 6-month semiannual reporting period of October 1, 2020, through March 31, 2021 (the Semiannual Reporting...more

Oberheiden P.C.

ZPIC Audits: What Healthcare Providers Need to Know

Oberheiden P.C. on

Zone Program Integrity Contractors (ZPICs) are federal contractors that work under the direction of the Centers for Medicare and Medicaid Services (CMS) to uncover fraudulent billings under Medicare. ZPICs have broad...more

ArentFox Schiff

Investigations Newsletter: Ten Individuals Charged for $1.4 Billion Health Care Billing Scheme

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Ten Individuals Charged for $1.4 Billion Health Care Billing Schemem - On June 29, an indictment was unsealed charging ten individuals with health care fraud and wire fraud for allegedly participating in a pass-through...more

Williams Mullen

Civil Investigative Demands and ZPIC Audits Can Be Traps for the Unwary

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Many people reasonably expect that when the government is targeting a company or individual for some adverse action, they will know it—there will be a lawsuit, an indictment, or some other clear demarcating event. ...more

Bradley Arant Boult Cummings LLP

Attention Healthcare Companies! New Strike Force Based in Nashville Means New Scrutiny - Government Enforcement Update

It’s Time to Review Your Compliance, Data and Auditing Plans - As we near the end of 2018, healthcare providers and companies are understandably focused on 2019 and the trends ahead. In planning for next year, however,...more

Arnall Golden Gregory LLP

Tampa Physician Sentenced to Prison for Obstructing Medicare Audit

On Friday, September 14, 2018, U.S. District Judge Steven Merryday for the Middle District of Florida sentenced Dr. John Janick of Port Charlotte to five months in prison and three years of supervised release, plus...more

Robinson+Cole Health Law Diagnosis

Connecticut Legislature Revises DSS Provider Audit Processes

On June 1, 2018, Connecticut Governor Dannel P. Malloy signed into law Public Act No. 18-76 “An Act Concerning Audits of Medical Assistance Providers” (PA 18-76), which makes several changes to the Medicaid provider audit...more

McAfee & Taft

CMS Audit Practices: How false can you get?

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Caring Hearts Personal Home Care Services provided physical therapy and skilled nursing services to homebound Medicare patients. During an audit, CMS determined that Caring Hearts provided services to patients who didn’t...more

Foley & Lardner LLP

Roadmap to Prison: Lessons Learned from the Criminal Prosecution of Alpha Ambulance’s Leaders

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No one running an ambulance company ever planned to go to prison for doing his or her job. But that is a real possibility if the government knocks on the door, and the owner or manager is dishonest in his or her response to...more

Akerman LLP - Health Law Rx

Efforts to Stop Health Insurance Fraud Through Use of Contractors Under Fire

In recent reports, from June 25, 2014 and August 13, 2014, the Government Accountability Office (GAO) highlights the mixed results achieved by the federal government's increased efforts to crack down on health insurance fraud...more

Baker Donelson

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

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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

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