The following is a summary of the federal Department of Health and Human Services’ Office of Inspector General (OIG) reports of fraud and abuse enforcement activity across the country. The enforcement actions reported are...more
9/7/2022
/ Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
Enforcement ,
False Claims Act (FCA) ,
Food and Drug Administration (FDA) ,
Fraud and Abuse ,
Health Care Providers ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare Fraud ,
Kickbacks ,
Medicaid ,
OIG ,
Paycheck Protection Program (PPP) ,
Qui Tam ,
Rebates ,
Trade Agreements Act
The Department of Health and Human Services’ Office of Inspector General (“OIG”) has offered an opinion on providing a gift card to certain Medicare Advantage plan enrollees who complete specific steps in an online patient...more
This opinion regards the provision of a gift card to certain Medicare Advantage (“MA”) plan enrollees who complete specific steps in an online patient education program....more
The following is a summary of the federal Department of Health and Human Services’ Office of Inspector General (OIG) reports of fraud and abuse enforcement activity across the country. The enforcement actions reported are...more
8/19/2022
/ Anti-Kickback Statute ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Durable Medical Equipment ,
Enforcement ,
False Claims Act (FCA) ,
Fraud ,
Health Care Providers ,
Kickbacks ,
Medicaid ,
Medicare Fraud ,
OIG ,
Telemedicine
The following is a summary of the federal Department of Health and Human Services’ Office of Inspector General (OIG) reports of fraud and abuse enforcement activity across the country. The enforcement actions reported are...more
8/9/2022
/ Bribery ,
Civil Monetary Penalty ,
Compliance ,
Department of Justice (DOJ) ,
Enforcement ,
False Claims Act (FCA) ,
Fraud ,
Kickbacks ,
Medicaid ,
OIG ,
Prior Authorization ,
Risk Assessment ,
Risk Management ,
Skilled Nursing Facility
On August 3, 2022, the New York State Department of Health (“DOH”) published an MRT Listserv notice announcing the launch of the Health Care & Mental Hygiene Worker Bonus (HWB) Program and Submission Portal.
The Health...more
The following is a summary of the federal Department of Health and Human Services’ Office of Inspector General (OIG) reports of fraud and abuse enforcement activity across the country.[1] The enforcement actions reported are...more
8/3/2022
/ Anti-Kickback Statute ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Enforcement ,
ESRD ,
False Claims Act (FCA) ,
Fraud and Abuse ,
Healthcare Fraud ,
Identity Theft ,
Kickbacks ,
Medicare Advantage ,
Medicare Fraud ,
OIG ,
Opioid ,
Stark Law
On July 27, 2022, the New York State Office of Mental Health (OMH) published in the New York State Register an Emergency Rule Making related to Telehealth Services. These regulations make permanent many of the flexibilities...more
On July 20, the Office of Inspector General (“OIG”) for the Department of Health and Human Services published a Special Fraud Alert on Telemedicine. Over the last year, as telehealth services expanded dramatically during the...more
The July 13, 2022 New York State Register published a summary of the New York State Office of the Medicaid Inspector General’s (“OMIG”) Proposed Rulemaking on Medicaid Program Fraud, Waste and Abuse Prevention. As Proposed...more
The following is a summary of the federal Health and Human Services agency’s Office of Inspector General (OIG) reports of fraud and abuse enforcement activity across the country. The enforcement actions reported are based...more
7/8/2022
/ Anti-Kickback Statute ,
CARES Act ,
Centers for Disease Control and Prevention (CDC) ,
Compliance ,
Coronavirus/COVID-19 ,
Durable Medical Equipment ,
Enforcement ,
False Claims Act (FCA) ,
Fraud and Abuse ,
Healthcare ,
Kickbacks ,
Medicaid ,
Medicare ,
Medicare Advantage ,
OIG ,
Opioid ,
Popular ,
Risk Assessment ,
Skilled Nursing Facility ,
TRICARE
Department of Health and Human Services Office of Inspector General (“OIG”)
Advisory Opinion 22-13 Issued:
June 23, 2022
This opinion addresses a durable medical equipment (“DME”) manufacturer’s arrangements with...more
The following is a summary of the federal Health and Human Services agency’s Office of Inspector General (OIG) reports of fraud and abuse enforcement activity across the country. The enforcement actions reported are based...more
6/24/2022
/ Anti-Kickback Statute ,
Compliance ,
Controlled Substances ,
Department of Health and Human Services (HHS) ,
Enforcement ,
False Claims Act (FCA) ,
False Statements ,
Federal Debt Collection ,
Fraud and Abuse ,
Genetic Testing ,
Healthcare ,
Healthcare Fraud ,
Mail Fraud ,
Medi-Cal ,
Medicaid ,
Medicare Fraud ,
OIG ,
Popular ,
Risk Assessment ,
TRICARE ,
Wire Fraud
On May 26, the New York State Department of Health (“DOH”) published the 2022 Value Based Payment (VBP) Reporting Requirements Technical Specifications Manual, available on the DOH website. Value Based Payment (VBP) refers to...more
Earlier this month, the New York State Department of Health announced that Brett Friedman, who replaced Donna Frescatore in 2021 as the New York State Medicaid Director, is leaving the Medicaid Program. The Commissioner of...more