January 28 was designated as “health day” for President Joe Biden’s early push of executive orders, with two new executive actions added to a growing list. The Executive Order on Strengthening Medicaid and the Affordable Care...more
Just when all things Affordable Care Act appeared to have settled in Congress, a federal district court in Texas has weighed in and ruled that the ACA—implemented over the last eight years and central to the nation’s...more
The final rule relaxes the requirements on “identification” and look-back period.
The Centers for Medicare & Medicaid Services (CMS) has released its long-awaited final rule related to the reporting and refunding of...more
The court’s interpretation complicates the already difficult task providers face in having sufficient time to assess and quantify potential overpayments.
An August 3 decision in United States v. Continuum Health Partners...more
8/6/2015
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Health Care Providers ,
Healthcare ,
Hospitals ,
Medicaid ,
Medicare ,
Overpayment ,
Qui Tam ,
Relators
Although CMS has not yet issued a final rule on the ACA’s 60-day repayment provisions, hospitals and other providers can still create policies and train staff in a manner that gives them some measure of protection. Even with...more
6/3/2015
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Chief Compliance Officers ,
Compliance ,
Health Care Providers ,
Hospitals ,
Medicaid ,
Medicare ,
Medicare Part A ,
Medicare Part B ,
Overpayment
The proposed rule to give providers more protections to promote beneficiary access to care solicits significant industry input.
On October 2, the Department of Health and Human Services (HHS) Office of Inspector...more
10/6/2014
/ Affordable Care Act ,
Anti-Kickback Statute ,
Civil Monetary Penalty ,
Gainsharing ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Hospitals ,
OIG ,
Proposed Regulation ,
Safe Harbors
OIG continues its aggressive interpretation of scope and effect of exclusion from participation in Federal health care programs and clarifies several open questions....more