Medicaid, OIG | JD Supra Law News

OIG Issues Updated Bulletin on Exclusion from Federal Health Care Programs

by Aaron Graham | Bradley Arant Boult Cummings LLP on 5/14/2013

On May 8, 2013, the Office of Inspector General (OIG) issued an updated Special Advisory Bulletin on the effect of exclusion from federal health care programs. A federal health care program (e.g., Medicare and Medicaid) is...more

HHS Extends Sunset Date for Stark Exception and Anti-Kickback Safe Harbor for EHR Donations

by Daniel F. Gottlieb | McDermott Will & Emery on 4/19/2013

The Centers for Medicare & Medicaid Services and the U.S. Department of Health and Human Services issued proposed rules that would extend the sunset date for the Stark Law exception and the federal Anti-Kickback Statute safe...more

Health Care Reform Update -- April 15, 2013

by Joseph P. Hammang, Alexander Hecht, Tom Koutsoumpas, Jeremy Rabinovitz, Robert C. Skinner | Mintz Levin - Health Law on 4/16/2013

In This Issue: Leading the News; Implementation of the Affordable Care Act (ACA); Other HHS and Federal Regulatory Initiatives; Other Congressional and State Initiatives; Other Health Care News; and Hearings and...more

Illinois Office of the Inspector General Self-Disclosure Protocol for Reporting Medicaid Overpayment

by Nicholas Lynn | Duane Morris LLP on 4/8/2013

The Illinois Department of Healthcare and Family Services ("Department"), Office of Inspector General ("OIG"), has now issued an Informational Notice and Voluntary Provider Self-Disclosure Protocol ("Protocol") providing...more

HEALTH REFORM: OIG Issues Updated Guidelines for Evaluating State False Claims Acts: Is More State Litigation on the Horizon?

by George Breen, Daniel C. Fundakowski, Wendy C. Goldstein | Epstein Becker & Green, P.C. on 4/1/2013

On March 15, 2013, the U.S. Department of Health and Human Services’ Office of Inspector General (“OIG”) released the Updated OIG Guidelines for Evaluating State False Claims Acts (“2013 Guidelines”), which replaces the...more

OIG Issues Favorable Advisory Opinion on FQHC Limited Issuance of Gift Cards

by King & Spalding on 3/21/2013

In a recent favorable advisory opinion, the OIG reviewed a Federally qualified health center’s (FQHC) proposal to offer $20 grocery store gift cards to certain patients in capitated managed care plans as an incentive for such...more

State Medicaid Enforcement Efforts Net $2.9 Billion in Recoveries for FY 2012

by Mintz Levin - Health Law on 3/7/2013

New state health care fraud recovery statistics reinforce that both the federal and state governments remain committed to health care fraud enforcement and demonstrate that their efforts are paying dividends. Earlier this...more

OIG Reports that Millions of Medicaid Overpayments Remain Uncollected

by King & Spalding on 2/28/2013

On February 19, 2013, the OIG published a report detailing the collection status of Medicaid overpayments. The Secretary of HHS requires CMS to collect overpayments, defined as “the amount paid by a Medicaid agency to a...more

CR7631: Changes to Place of Service Coding Effective April 1, 2013

by Stacey Borowicz, Simi Botic | Dinsmore & Shohl LLP on 2/7/2013

After the OIG identified a high error rate for Place of Service (“POS”) modifiers over several years, the Centers for Medicare and Medicaid (“CMS”) issued a billing and coding revision (CR 7631) to instruct any physician,...more

OIG Advisory Opinion Sheds Light On Pay-For-Performance Relationships Between Hospitals And Physicians

by Darby C. Allen, Donna S. Clark | BakerHostetler on 1/20/2013

On January 7, 2013, the HHS OIG released Advisory Opinion 12-22 concerning a rural hospital's (Hospital) proposal to pay a cardiology group (Group) a performance bonus for achieving certain patient service, quality and cost...more

OIG: Cardiac Catheterization Arrangement Between Hospital and Physicians Not Subject to Sanctions

by King & Spalding on 1/18/2013

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

Health Reform + Related Health Policy News Update - January 16, 2013

by Colleen M. Faddick, Bruce A. Johnson, Matthew Murer, Alan K. Parver | Polsinelli on 1/18/2013

In This Issue: - Fiscal Cliff Deal Lengthens Medicare Overpayment Recovery Period - Cutting Medicaid Provider Tax May Shift Costs to States, CRS Finds - MedPAC Finalizes Payment Recommendations, GAO Solicits...more

Payment Matters: Extension of Time for Overpayment Recoveries in Fiscal Cliff Law Not as Broad as it Sounds

by Thomas W. Coons, Leslie Demaree Goldsmith | Ober|Kaler on 1/18/2013

The recently passed fiscal cliff legislation, i.e., the American Taxpayer Relief Act of 2012 (Act) [PDF], includes a number of provisions addressing Medicare and Medicaid. One of these provisions extends the recovery period...more

OIG Approves Gift Cards to Encourage Clinical Visits to Health Center

by Roy M. Albert, Theresa C. Carnegie | Mintz Levin - Health Law on 1/10/2013

In Advisory Opinion 12-21, the OIG concluded that a Federally qualified health center’s offer of grocery store gift cards to capitated managed care patients would not constitute grounds for the imposition of sanctions under...more

Navigating the Provider Self-Disclosure Protocol

by Barbara Taylor | Sheppard Mullin Richter & Hampton LLP on 12/29/2012

Providers can voluntarily disclose potential fraud with respect to Federal health care programs — Medicare, Medicaid, and potentially private insurers to the extent Federal or state funds are involved — by following the...more

OIG’s Compendium of Unimplemented Recommendations Highlights Opportunities for Action in FY2013

by King & Spalding on 12/20/2012

The HHS Office of Inspector General (OIG) recently released its 2012 Compendium of Unimplemented Recommendations (the “Compendium”), a report that summarizes significant monetary and nonmonetary recommendations as a result of...more

OIG Recommends Additional Oversight of EHR Incentive Programs

by King & Spalding on 12/13/2012

A November 29, 2012 report from the HHS Office of Inspector General (OIG) sets forth several recommendations to improve CMS’s oversight of the Medicare and Medicaid EHR Incentive Programs. Specifically, the report expresses...more

Health Reform + Related Health Policy News - November 28, 2012

by Colleen M. Faddick, Bruce A. Johnson, Matthew Murer, Alan K. Parver | Polsinelli on 12/3/2012

In This Issue: - CMS Releases FY 2012 Financial Report; Misses Target forReductions in Improper Payments - CMS Releases Guidance on Medicaid/CHIP Issues - HHS Secretary Extends Deadline for Decision on...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

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