The Centers for Medicare and Medicaid Services (CMS) recently published a proposed rule modifying certain provisions in their Incentive Reward Program (IRP) to sweeten the incentives for reporting sanctionable conduct....more
The Sixth Circuit Court of Appeals recently issued a decision overturning an $11.1 million False Claims Act (FCA) verdict against MedQuest Associates, Inc. (MedQuest) for submitting claims to Medicare in violation of the...more
On April 17, 2013, the U.S. Department of Health and Human Services Office of Inspector General (OIG) published a revised Provider Self-Disclosure Protocol (SDP) that clarifies the process for healthcare providers, suppliers...more
On March 18, the Centers for Medicare and Medicaid Services (CMS) published in the Federal Register two important documents addressing the hotly contested issue of a hospital's ability to obtain payment under Part B for...more
Last week, the U.S. Department of Health and Human Services (HHS) and the DOJ jointly released a report concluding that, for every dollar spent on healthcare fraud investigations in the last three years, the government...more
On February 5, 2013, CMS issued its mandatory Recovery Audit Contractor (RAC or Recovery Auditor) program annual report, detailing overpayments, underpayments, RAC performance and savings to the Medicare program. According to...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
In This Issue:
- Healthcare Provisions in the American Taxpayer Relief Act - the Good, the Bad and the Ugly
- American Taxpayer Relief Act Amends Overpayment Recovery Time Limits
- OIG Advisory Opinion Sheds...more
1/14/2013
/ American Taxpayer Relief Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Data Breach ,
Electronic Medical Records ,
Fraud ,
Healthcare ,
OCR ,
OIG ,
Overpayment Recovery Time Limits ,
Pay-for-Performance ,
Reporting Requirements ,
Settlement
The OIG recently published a report reviewing the implementation of 2005 regulations regarding the administrative law judge (ALJ) level of appeals, the third level of the Medicare appeals system. The 2005 regulatory changes...more