The US Department of Health and Human Services Office of Inspector General (OIG) recently released Advisory Opinion No. 23-07, in which OIG approved a proposed arrangement to pay employed physicians bonuses based on net...more
Healthcare providers are scrambling to understand the impacts of the May 11 expiration of the COVID-19 public health emergency (PHE). Luckily for most telehealth providers, the outlook of their operations post-PHE is...more
On October 3, the Office of Inspector General (OIG) of the US Department of Health and Human Services issued a report titled “UPICs Hold Promise to Enhance Program Integrity Across Medicare and Medicaid, But Challenges...more
The recent increase in use of telehealth as a care modality has been important to patients and providers alike, with significant benefits for public health. However, with the growing mainstream acceptance of virtual care, the...more
Perhaps signaling the increasing likelihood of a permanent telehealth solution for the Medicare program, the Office of Inspector General for the US Department of Health and Human Services (OIG) has established a “Featured...more
Last month, we had an engaging Fast Break session covering the growing importance of risk adjustment in various health insurance programs and novel government theories of liability associated with risk adjustment reporting....more
We hope you were able to join us for our July Fast Break on the US Court of Appeals for the Fourth Circuit's recently affirmed $114 million judgment in United States v. Mallory. If not, you missed a great session, featuring...more
The US Department of Health and Human Services Office of Inspector General (OIG), the Department of Justice (DOJ), and other federal regulators have grown increasingly concerned about the use of telehealth technologies by...more
Powerfully illustrating the efforts of the US Department of Health and Human Services (HHS) to transform the US healthcare system to a value-based model, the Office of the Inspector General (OIG) and the Centers for Medicare...more
11/25/2020
/ Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Fraud and Abuse ,
Health Care Providers ,
Healthcare Fraud ,
Healthcare Reform ,
OIG ,
Rulemaking Process ,
Safe Harbors ,
Stark Law ,
Value-Based Care
As we noted in our previous Health Law Scan blog CMS Issues Program Instructions for Medicare Telehealth Waiver, CMS issued program instructions on March 17 to implement the Medicare telehealth waiver in response to the...more
3/20/2020
/ Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
Facebook ,
FaceTime ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Medicare ,
OCR ,
OIG ,
Public Health Emergency ,
Skype ,
Telehealth ,
Waivers
Highlighting the US Department of Health and Human Services’ (HHS) efforts to transform the US healthcare system to a value-based model, the Office of the Inspector General (OIG) and the Centers for Medicare and Medicaid...more
The Office of Inspector General Portfolio Report is a rehash of the watchdog agency’s 2006–2016 findings on quality of care concerns and program integrity issues. The report, which garnered some critical press attention for...more
OIG Advisory Opinion paves the way for expanded retailer reward programs.
The US Department of Health and Human Services Office of Inspector General (OIG) issued an advisory opinion on September 7 that provides important...more
The report shows significant lapses in 2012 GIP service claims and recommends that CMS implement additional oversight and enforcement options....more
The OIG’s recently released study examining Medicare hospice claims from 2007 to 2012 calls for targeted reviews of hospices that receive a high proportion of their payments for care in assisted living facilities....more
CMS reconsiders $10 million bounties for reporting of regulatory violations.
On December 5, the Centers for Medicare & Medicaid Services (CMS) finalized a rule (the Final Rule) that expands its program integrity and...more
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