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Medicaid › Investigations

Medicaid is a partnership program between states and the federal government to provide healthcare coverage for lower income individuals, people with disabilities, older people, and certain families with... more +
Medicaid is a partnership program between states and the federal government to provide healthcare coverage for lower income individuals, people with disabilities, older people, and certain families with children.  less -
Mintz - Health Care Viewpoints

DOJ Releases COVID-19 Fraud Enforcement Task Force Report Touting Its Successes and Urging Lawmakers to Enact New Legislation

Mintz - Health Care Viewpoints on

The government’s continued dedication of resources to investigating and prosecuting fraud against COVID-19 pandemic relief programs appears to have borne fruit according to the results of the COVID-19 Fraud Enforcement Task...more

Society of Corporate Compliance and Ethics...

[Event] Regional Compliance & Ethics Conference - May 3rd, Lewis Center, OH

Society of Corporate Compliance and Ethics... on

Looking for compliance education and networking in your area? SCCE & HCCA’s Regional Compliance & Ethics Conferences bring compliance practitioners from all disciplines together for convenient, local compliance education....more

Health Care Compliance Association (HCCA)

[Event] Regional Compliance & Ethics Conference - May 3rd, Lewis Center, OH

Health Care Compliance Association (HCCA) on

Looking for compliance education and networking in your area? SCCE & HCCA’s Regional Compliance & Ethics Conferences bring compliance practitioners from all disciplines together for convenient, local compliance education....more

Harris Beach PLLC

New York OMIG Posts 2024 Work Plan

Harris Beach PLLC on

On January 3, 2024, the New York State Office of the Medicaid Inspector General (“OMIG”) posted its 2024 Work Plan. This is the first update since its 2019 – 2020 Work Plan and OMIG notes that the Work Plan does not reflect...more

Bass, Berry & Sims PLC

False Claims Act Decisions to Know from Q3 2023

Bass, Berry & Sims PLC on

Below are noteworthy False Claims Act (FCA) decisions from the third quarter of 2023. The main issues in the cases are: Materiality. The Fourth Circuit held that a pharmacist’s efforts to falsify patient eligibility...more

King & Spalding

OIG Publishes the Spring 2023 Semiannual Report to Congress

King & Spalding on

OIG released its Semiannual Report to Congress (the Report) which summarizes the agency’s activities from October 1, 2022, through March 31, 2023 (the Reporting Period). Among other accomplishments, the Report highlights...more

Lippes Mathias LLP

OMIG to Adopt New Fraud, Waste and Abuse Prevention Requirements

Lippes Mathias LLP on

In the July 13, 2022 issue of the New York State Register, the New York State Office of Medicaid Inspector General (OMIG) published a proposed regulation that it will likely adopt this fall. The proposed regulation will add...more

Health Care Compliance Association (HCCA)

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

Health Care Compliance Association (HCCA) on

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

Foley & Lardner LLP

What’s New in ’22: More DOJ-Driven False Claims Act Investigations

Foley & Lardner LLP on

On February 1, 2022, the Department of Justice (DOJ) issued its annual release touting its latest accomplishments in the False Claims Act field, advertising another multibillion-dollar year in recoveries; $5.6 billion makes...more

BakerHostetler

Biden's New HHS Secretary Promises "Robust Enforcement"

BakerHostetler on

Introduction - On March 18, 2021, the Senate narrowly confirmed Xavier Becerra, the former attorney general of California, as U.S. Department of Health and Human Services (“HHS”) Secretary....more

Bass, Berry & Sims PLC

Tennessee Government Update - January 2021

Bass, Berry & Sims PLC on

The 112th General Assembly of the state of Tennessee convened on Tuesday, January 12, for an organizational session to begin the first year of the two-year session. During the organizational session, members were sworn in and...more

Sheppard Mullin Richter & Hampton LLP

Maneuvers on the 340B Drug Pricing Program Battlefield: Duplicate Discounts and Contract Pharmacies

Sheppard Mullin Richter & Hampton LLP on

In a December 12, 2017 Advisory Board article, “The 340B drug pricing controversy, explained,” Scott Orwig wrote, “the 340B Drug Pricing Program is one of the most contentious issues in health care: Its critics say it ‘hurts...more

Sheppard Mullin Richter & Hampton LLP

Nursing Home Liability Waivers and Nursing Home Investigations and Enforcement: A Delicate Balance During the COVID-19 Pandemic

Sheppard Mullin Richter & Hampton LLP on

As we discussed in our April 27, 2020 blog post, nursing homes have become the focus of significant attention during the COVID-19 crisis. In many respects, the attention is well deserved: 1. Nursing homes traditionally...more

Health Care Compliance Association (HCCA)

[Event] 2020 Clinical Practice Compliance Conference - October 26th - 28th, Atlanta, GA

Health Care Compliance Association (HCCA) on

Our annual Clinical Practice Compliance Conference provides information about the latest government initiatives related to physicians and clinics, and physician integrity trends. Unite with your colleagues to discuss...more

Stinson - Corporate & Securities Law Blog

SEC Brings Enforcement Action for Loss Contingency Disclosure

Stinson - Corporate & Securities Law Blog on

The SEC recently settled an enforcement action against Mylan N.V., claiming Mylan failed to timely disclose to investors a possible loss relating to a nearly two-year Department of Justice  probe into whether Mylan...more

Mintz - Health Care Viewpoints

OIG Releases FY 2016 Statistical Data About Medicaid Fraud Control Units

Mintz - Health Care Viewpoints on

Earlier this week, the Office of Inspector General for the Department of Health and Human Services (“OIG”) posted its fiscal year (“FY”) 2016 data about Medicaid Fraud Control Units (“MFCUs”) across the country....more

Polsinelli

Proposed Rule to Strengthen State Medicaid Fraud Control Units

Polsinelli on

A recently published proposed rule expands the functions and responsibilities of state Medicaid Fraud Control Units (MFCUs). The rule was issued by the Centers for Medicare and Medicaid Services (CMS) and the Office of...more

Cooley LLP

Blog: HHS OIG Hands Out 2015 Work Plan For Halloween

Cooley LLP on

On Friday October 31, 2014, the U.S. Department of Health & Human Services (HHS) Office of Inspector General (OIG) released its annual “Work Plan” for fiscal year 2015. The Work Plan is a compilation of the OIG’s plans for...more

King & Spalding

CMS Announces New Unified Program Integrity Contractors

King & Spalding on

CMS recently announced plans to implement a new Medicare and Medicaid program integrity contractor, Unified Program Integrity Contractors (UPICs). ...more

King & Spalding

Healthcare Sector Under Scrutiny: Congressional Oversight of the Affordable Care Act by Daniel F. Donovan and William Clarkson

King & Spalding on

"I've long maintained that there are three possible routes to repeal of ObamaCare: the courts, the presidential election, and our constitutional responsibility for oversight. With two of them having come up short, the third...more

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