Individuals and entities subject to the Civil Monetary Penalty Law (CMP) have received clarification regarding the process for disclosing and resolving potentially unlawful conduct involving the federal health care programs...more
On April 17, 2013, the Office of Inspector General of the Department of Health and Human Services (“OIG”) released an Updated Provider Self-Disclosure Protocol (“SDP”). The Updated SDP replaces OIG’s original Provider...more
The Department of Health and Human Services Office of Inspector General (“OIG”) has published an updated Provider Self-Disclosure Protocol (the “Updated SDP”) that offers health care providers guidance on how to disclose...more
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
Amid alleged failures of skilled nursing facilities to meet care and discharge planning requirements, OIG identifies substantial payment errors....more
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
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
The HHS OIG has conducted a nationwide audit of the use and reimbursement of Herceptin (also known as trastuzumab), a Medicare-covered drug used to treat metastatic breast cancer, and has concluded in three audits released in...more
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
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
The ATRA significantly alters provider rights related to overpayment recoupment, refunds, audits and claims appeals. A provision entitled "Removing obstacles to collection of overpayments" increases the statute of limitations...more
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