News & Analysis as of

Fraud Abuse and Waste Health Care Providers

Holland & Knight LLP

OIG Releases New Compliance Program Guidance for All Healthcare Stakeholders

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The Office of Inspector General of the U.S. Department of Health and Human Services (OIG) on Nov. 6, 2023, issued new General Compliance Program Guidance (GCPG) as a reference guide for the healthcare compliance community....more

Manatt, Phelps & Phillips, LLP

[Webinar] Emerging Fraudulent Schemes in Health Care: A Guide to Protecting Plan and Provider Organizations - October 17th, 10:00...

Over the past few years, there has been tightening enforcement and numerous lawsuits driven by the increasingly complex web of federal and state anti-kickback and anti-inducement statutes. In a new CLE-eligible webinar,...more

Holland & Knight LLP

Information Blocking Enforcement Penalties Begin Sept. 1, 2023

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The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) recently posted the final rule establishing civil monetary penalties (CMPs) for information blocking (IB Enforcement Rule). The Rule...more

Harris Beach PLLC

OMIG Fraud, Waste and Abuse Engagement Sessions Slide Presentation

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The New York State Office of the Medicaid Inspector General (“OMIG”) conducted three statewide sessions to outline its audit process as it pursues its mission to prevent and detect fraud, waste and abuse in the Medicaid...more

Health Care Compliance Association (HCCA)

[Webinar] Healthcare Fraud, Waste, & Abuse Investigations - May 2nd, 12:00 pm - 1:30 pm CT

Learning Objectives - The importance of developing investigation standards - How to avoid regency bias when conducting investigations - Presenting your investigation findings to stakeholders (OIG, AG, MFCU, etc.)...more

Manatt, Phelps & Phillips, LLP

NY OMIG Finalizes Omnibus Regs Impacting Medicaid Providers’ and Plans’ Compliance Obligations

On December 28, 2022, the New York State Office of the Medicaid Inspector General (OMIG) finalized the proposed rule published on July 13, 2022, that significantly revises the provider and Medicaid managed care organization...more

Sheppard Mullin Richter & Hampton LLP

Attention New York Medicaid Providers: It’s Time to Upgrade Your Compliance Program

On January 31, 2023, the New York State Office of the Medicaid Inspector General (OMIG) released three guidance documents to assist Medicaid providers in meeting the requirements of recently adopted regulations governing (i)...more

Rivkin Radler LLP

OMIG Update: Compliance, Self-Disclosure, and Managed Care Fraud, Waste and Abuse Guidance Posted

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On the heels of publishing their final regulations, on January 31, the New York Office of the Medicaid Inspector General (OMIG) released a variety of guidance documents addressing compliance programs; self-disclosure; and...more

Rivkin Radler LLP

[Webinar] Lunch and Learn Series: OMIG's FINALIZED Regulations: What You Need to Do - NOW! - February 9th, 12:00 pm - 1:00 pm ET

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Please join us on February 9 as Partner Bob Hussar and Associates Ashley Algazi and Mary Connolly present on OMIG’s finalized regulations. On December 28th, the Office of Medicaid Inspector General (OMIG) released their...more

Bond Schoeneck & King PLLC

New OMIG Compliance Rules Effective

Effective Dec. 28, 2022, the Office of the Medicaid Inspector General’s (OMIG) revised Part 521 compliance regulations became effective. First proposed in July 2022 for review and comment, only minor, technical changes to the...more

Rivkin Radler LLP

[Webinar] Lunch and Learn Series: Avoiding the Pitfalls in Recent Government Enforcement - December 8th, 12:00 pm - 1:00 pm ET

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Please join us for the December Lunch and Learn with Benjamin Malerba and Benjamin Wisher. The pair will discuss recent audits, investigations and actions of government agencies including DOJ, MFCU, OMIG, the NY AG and...more

Benesch

OIG Provides Insight as to Risky Billing Practices for Medicare Telehealth Services

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​​​​​​​As part of the Federal government’s response to the COVID-19 pandemic, the coverage of telehealth services by Medicare was greatly expanded by CMS through the COVID-19 telehealth waivers. Further expansion of...more

Hanzo

[Webinar] Luminary Series: Five Healthcare Litigation Trends For 2022 - A Discussion with Jon Braunstein, Partner at Dentons -...

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Health care is a highly innovative, lucrative, and regulated industry, which also makes it a highly litigious industry. From a legal perspective, it makes sense for practitioners to pay close attention to trends happening in...more

Rivkin Radler LLP

[Webinar] Lunch & Learn Series: New OMIG Compliance Regulations: What You Need to Know - July 28th, 12:00 pm - 1:00 pm ET

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On July 13, the Office of Medicaid Inspector General (OMIG) published proposed regulations implementing 2020 changes to law relating to provider compliance programs, Medicaid managed care fraud, waste and abuse prevention...more

Rivkin Radler LLP

[Webinar] Lunch & Learn Series: New OMIG Compliance Regulations: What You Need to Know - July 27th, 12:00 pm - 1:00 pm ET

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On July 13, the Office of Medicaid Inspector General (OMIG) published proposed regulations implementing 2020 changes to law relating to provider compliance programs, Medicaid managed care fraud, waste and abuse prevention...more

Health Care Compliance Association (HCCA)

[Virtual Event] Ann Arbor and Columbus Regional Healthcare Compliance Conference - June 24th, 8:25 am - 4:30 pm EDT

General and specialty compliance training from the comfort of your home or office! HCCA’s Regional Healthcare Compliance Conferences provide practitioners with virtual compliance training that includes updates on the...more

Health Care Compliance Association (HCCA)

[Event] Research Compliance Conference - June 8th - 10th, Anaheim, CA

Hear about the latest in research compliance - Do you want to learn… - How to prepare for upcoming changes in Medicaid? - Ways to build and maintain a better research compliance work plan for your program? - How...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

Goodwin

OIG Advocates for Increased Oversight of Medicaid Telehealth Services in Behavioral Health

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Telehealth’s exponential growth –in part due to the COVID-19 pandemic – has highlighted both its value in increasing access to care and the potential for misuse. The U.S. Department of Health and Human Services’ Office of...more

Goodwin

Federal Audits and Enforcement Actions of Telehealth Providers: Future Trends and Mitigating Risk

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As the COVID-19 pandemic progresses and the expanded use of telehealth has appeared to stabilize over the past year according to a July report from McKinsey & Company, Federal agencies have continued the recent trend of...more

K&L Gates LLP

Health Care Triage: Health Care Audit and Reimbursement Trends and Challenges

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In this week’s episode, Richard Church interviews Stephen Bittinger about current trends and points of concern in the areas of health care reimbursement and integrity audit activity. The presenters discuss increases in...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 30, Number 13. News Briefs: April 2021

Report on Medicare Compliance 30, no. 13 (April 5, 2021) - Because of the COVID-19 pandemic, CMS said April 1 that it won’t update the 855 enrollment form with sections on “affiliation disclosures,” as planned in a 2019...more

Health Care Compliance Association (HCCA)

Report on Patient Privacy Volume 20, Number 8. Privacy Briefs: August 2020

Report on Patient Privacy 20, no. 8 (August 2020)  -  HHS changed its tone on care coordination and case management in the final Confidentiality of Substance Use Disorder Patient Records regulation (42 C.F.R. § 2), known...more

Health Care Compliance Association (HCCA)

[Virtual Event] 2020 Virtual Regional Healthcare Compliance Conference - Minneapolis, MN - September 11th, 8:30 am - 4:30 pm CDT

Our Virtual Regional Healthcare Compliance Conferences provide updates on the latest news in regulatory requirement, compliance enforcement, and strategies to develop effective compliance programs. Watch, listen, and ask...more

Health Care Compliance Association (HCCA)

[Webinar] Telehealth During a Time of Crisis: Integrating Remote Care Delivery into Your Compliance Program - May 27th, 12:00 pm...

Main Points Covered: - The COVID-19 crisis has severely impacted our nation’s healthcare delivery system - Many who needed care were unable to access doctors, hospitals, and other healthcare providers because of...more

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