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In its Semiannual Report to Congress, which covers the first half of fiscal year (FY) 2013 (October – March), the OIG announced expected recoveries of $3.8 billion, consisting of more than $521 million in audit receivables...more
Starting June 17, state Medicaid Fraud Control Units (MFCUs) can use federal funding to pay for data mining, according to a final rule published by the Department of Health and Human Services Office of Inspector General in...more
On Wednesday, April 17, 2013, the Department of Health and Human Services’ Office of Inspector General (OIG) released an updated Self-Disclosure Protocol (SDP) governing the process by which health care providers can...more
The U.S. Department of Health & Human Services, Office of Inspector General (the “OIG”) issued a Special Fraud Alert (“Alert”) on March 26, underscoring its heightened focus on fraud and abuse risks posed by physician-owned...more
On March 26, 2013, the U.S. Department of Health and Human Services Office of Inspector General (OIG) issued a Special Fraud Alert entitled “Physician-Owned Entities.” The Alert is consistent with an ongoing theme of concern...more
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
The government has been increasing its focus on healthcare fraud involving “quality” of care. This is an extremely difficult issue, especially for prosecutors. It is very difficult to define “quality” standards and then...more
It is always important to consider how different parts of the government handle voluntary disclosures. The FCPA enforcement initiative has been largely the result of the voluntary disclosure process, and the government...more
On January 7, 2013, HHS OIG published a favorable advisory opinion on a management arrangement between a hospital and a cardiology group related to the provision of certain cardiac catheterization services at the hospital. ...more
When it comes to healthcare fraud enforcement, the government knows how to target its resources. It is estimated that at least 25 percent of all claims paid by Medicare are improper. The government understands the...more
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
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
The Department of Justice continues to trumpet its healthcare fraud program. Just last week, the Justice Department and HHS announced another nationwide sweep resulting in the arrest of 91 individuals....more
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