CMS, Fraud | JD Supra Law News

CMS Proposes Increased Rewards for Reporting Fraud and Abuse

by Ameena Ashfaq, B. Scott McBride | BakerHostetler on 5/7/2013

The Centers for Medicare and Medicaid Services (CMS) recently published a proposed rule modifying certain provisions in their Incentive Reward Program (IRP) to sweeten the incentives for reporting sanctionable conduct....more

CMS Proposes Additional Incentives to Reduce Medicare Fraud Including Increase to Reward for Reporting Fraud

by King & Spalding on 5/1/2013

On April 24, 2013, CMS issued a proposed rule that would further incentivize Medicare beneficiaries and other individuals to report suspected Medicare fraud under the Medicare Incentive Reward Program. CMS is proposing to...more

White Collar Watch - April 2013

by Bruce D. Armon, Andrea P. Brockway, Michael Finio, Christopher R. Hall, Keith Lorenze, Nicholas J. Nastasi, Courtney L. Schultz, Brian Simons | Saul Ewing LLP on 4/23/2013

In This Issue: - Third Circuit Panel Liberalizes “Protected Activity” Immunity for Employees Claiming Whistleblower Status - Doing Time: A Requirement for White Collar Crime? - Casting a Smaller Net:...more

New Metropolitan Areas Could Affect Medicare Payment, Regulations

by Emily J. Cook, Eric Zimmerman | McDermott Will & Emery on 3/28/2013

The U.S. Office of Management and Budget recently announced new Metropolitan Areas based on revised standards and 2010 census data. If adopted by Medicare, which they typically are, these changes would affect many aspects of...more

CMS Focuses on Fraud Associated with Increased Use of Electronic Health Records

by Tom Crane | Mintz Levin - Health Law on 3/22/2013

Acting CMS Administrator, Marilyn Tavenner, recently reaffirmed the agency’s concern that the increased use of electronic health records (“EHRs”) has contributed to increases in fraudulent billing practices by providers. At a...more

GAO Report Concludes Medicare Remains High-Risk Federal Program Due to Failure to Lower Rate of Improper Payments

by King & Spalding on 3/12/2013

On February 27, 2013, the Government Accountability Office (GAO) released its High-Risk Update for Medicare and Medicaid, stating that “CMS has not met GAO’s criteria to have the Medicare program removed from the High-Risk...more

Hospitals And Fraud Enforcement

by Michael Volkov on 2/19/2013

The HHS Office of Inspector General has targeted hospitals for fraud enforcement. It is one of the OIG’s most important initiatives because of the impact it could have on reducing health care costs....more

OIG Recommends that CMS Recoup More Than $100 Million in Overpayments for Incarcerated and Unlawfully Present Beneficiaries

by King & Spalding on 1/31/2013

CMS made more than $100 million in improper payments to providers for healthcare services on behalf of incarcerated and unlawfully present individuals between 2009 and 2011, according to a pair of reports issued on January...more

OIG Report Calls for More Fraud and Abuse Investigations of Medicare Advantage Plans

by King & Spalding on 1/21/2013

The HHS OIG has released a report recommending that CMS grant the Medicare Drug Integrity Contractor (MEDIC) wider latitude in pursuing potential fraud and abuse by Medicare Advantage plans. The report found that the MEDIC,...more

Health Law Update — January 10, 2013

by Darby C. Allen, Ameena Ashfaq, Donna S. Clark, Susan Feigin Harris, Theodore Kobus III, B. Scott McBride, Lynn Sessions, Summer Swallow, Robert Wolin | BakerHostetler on 1/14/2013

In This Issue: - Healthcare Provisions in the American Taxpayer Relief Act - the Good, the Bad and the Ugly - American Taxpayer Relief Act Amends Overpayment Recovery Time Limits - OIG Advisory Opinion Sheds...more

Private Health Insurance Efforts To Fight Fraud

by Michael Volkov on 12/13/2012

Healthcare fraudsters do not discriminate between private and public health insurance. Fraudsters use similar schemes to defraud Medicare and Medicaid and private insurance companies. ...more

Plugging The Leak: Tackling The Problem Of Healthcare Fraud

by Michael Volkov on 12/11/2012

The Justice Department and the Department of Health and Human Services have made healthcare fraud a number one priority – it is another example of the synergy of politics and enforcement. Congress spends more money on...more

Birmingham Medical News: 2012 Health Care Year In Preview

by Howard E. Bogard | Burr & Forman on 12/6/2012

The health care events of 2012 can be properly divided into "Before" and "After": Before the Supreme Court ruling on the Affordable Care Act and President Obama's re-election and After. Before these two events, the viability...more

Who is Committing Healthcare Fraud?

by Michael Volkov on 10/26/2012

The financial recoveries for healthcare fraud are staggering. The Justice Department and Health and Human Services (Office of Inspector General (“OIG”) and Centers for Medicare and Medicaid Services (“CMS”)) regularly...more

Physician Payment Sunshine Act: Challenge for Companies, Tool for Enforcers

by Morrison & Foerster LLP on 10/22/2012

Pharmaceutical companies, medical device manufacturers, and biotech companies are gearing up for the January 1, 2013 deadline set by the Centers for Medicare and Medicaid Services (“CMS”) for companies to begin collecting...more

Payment Matters: Sovereign Immunity Extended to Medicare Contractors

by Ober|Kaler on 10/10/2012

Win or lose, one out of two clients ask this question after an ALJ hearing: Can we sue the contractors to recoup our legal and other costs? With the recent decision from the United States Court of Appeals for the Third...more

OIG and CMS Focus on the Identification and Reduction of Potential Fraud and Abuse in the Medicare Advantage Program

by Foley & Lardner LLP on 2/29/2012

On February 24, 2012, the Department of Health and Human Services Office of the Inspector General (OIG) published the results of its study entitled “Medicare Advantage Organizations’ Identification of Potential Fraud and...more

Home

Legal News

Find a Lawyer

Browse Subjects

Subscribe

Pro Services

For Reporters

Centers for Medicare & Medicaid Services › Fraud