News & Analysis as of September 19, 2024

Anti-Kickback Statute › Home Health Agencies

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The Anti-Kickback Statute is a United States federal criminal statute that prohibits the exchange (or the promise to exchange) of anything of value for referrals of federal healthcare program business. The statute aims to prevent situations where government officials channel federal healthcare dollars towards particular providers, who have offered or given the official a personal benefit. Penalties for violation of the Anti-Kickback statute apply to both sides of a prohibited transaction and can include jail time and steep monetary fines. less -

AGG Talks: Home Health & Hospice Podcast - Episode 5: Understanding Palliative Care: Strategies for Compliance and Reimbursement

Arnall Golden Gregory LLP on 7/12/2024

In this episode, AGG Post-Acute & Long-Term Care co-chair Jason Bring is joined by AGG Healthcare attorney Charmaine Mech to discuss the latest developments in the palliative care industry across the country. Jason and...more

OIG Issues Advisory Opinion for Payment of Tuition for CNA Certification for HHA Employees

King & Spalding on 2/17/2022

On February 14, 2022, OIG issued Advisory Opinion No. 22-03 analyzing a proposed arrangement under which home health agency (HHA) owners would pay tuition costs of nurse aid certification programs for new employees who are...more

OIG Issues Favorable Advisory Opinion Regarding Home Health Agency’s Proposal to Pay Tuition Costs for New Employees

Robinson+Cole Health Law Diagnosis on 2/15/2022

On February 14, 2022, the Office of Inspector General (OIG) issued Advisory Opinion No. 22-03 (Advisory Opinion) regarding a home health agency’s (Requestor) proposal to pay nurse aide certification tuition costs on behalf of...more

Investigations Newsletter: Home Health Agency Operator Agrees to Pay $17 Million to Resolve False Claims Act Allegations

ArentFox Schiff on 9/13/2021

A group of New Jersey home health care companies (collectively, the BAYADA Companies), have agreed to pay $17 million to resolve claims that they violated the False Claims Act and Anti-Kickback Statute. Home Health Agency...more

OIG Permits Medicaid Enrollment Application Assistance for SNF and HHA Patients

Baker Donelson on 2/10/2021

On December 23, 2020, the OIG published Advisory Opinion 20-06, concluding that it would not impose penalties or sanctions under either the beneficiary inducement prohibitions of the civil monetary penalty statute (CMP) or...more

OIG Issues Four Advisory Opinions

King & Spalding on 1/8/2021

From December 23, 2020 through December 31, 2020, the OIG issued several advisory opinions. The advisory opinions analyzed (1) a program for a pharmaceutical manufacturer to provide financial assistance to certain patients,...more

Fifth Circuit Upholds Health Care Fraud Convictions for Home Health Agency Employees

McGuireWoods LLP on 11/24/2020

The U.S. Fifth Circuit recently upheld convictions and sentences against five named defendants, each charged with conspiracy to commit health care fraud, conspiracy to violate the Federal Anti-Kickback Statute (AKS) and...more

Report on Medicare Compliance Volume 29, Number 39. News Briefs: November 2020

Health Care Compliance Association (HCCA) on 11/9/2020

Report on Medicare Compliance 29, no. 39 (November 2, 2020) - Medtronic USA Inc., a medical device maker, has agreed to pay $8.1 million to settle allegations it violated the False Claims Act by paying kickbacks to induce...more

Attempts by Recruiters to Avoid Kickback Prosecutions Using the “Bona Fide Employee” Safe-Harbor Fail

Arnall Golden Gregory LLP on 9/1/2020

On August 6, 2020, the United States Court of Appeals for the Sixth Circuit upheld the conviction of a patient recruiter in a Medicare kickback case, finding insufficient evidence to demonstrate that the recruiter was a “bona...more

Investigations Newsletter: Home Health Care Employees Plead Guilty in Multi-Million Dollar Medicaid Fraud Scheme

ArentFox Schiff on 1/24/2020

Home Health Care Employees Plead Guilty in Multi-Million Dollar Medicaid Fraud Scheme - Two individuals pled guilty in Pennsylvania federal court to conspiracy to defraud the Pennsylvania Medicaid program and commit...more

OIG Approves In-Home Follow-Up Care for COPD Patients in Advisory Opinion 19-03

Baker Donelson on 3/25/2019

In Advisory Opinion 19-03, the Office of Inspector General (OIG) approved a program proposed by a medical center that has been providing free, in-home follow-up care to eligible individuals with congestive heart failure...more

Coordinating Care, Reducing Burden: OIG Issues Favorable Advisory Opinion Regarding Follow-up Care Arrangements for Chronic...

Bradley Arant Boult Cummings LLP on 3/20/2019

As the industry eagerly awaits the outcome of the “Regulatory Sprint to Coordinated Care”—the multi-pronged, inter-agency initiative within the Department of Health and Human Services (HHS) to identify and remove barriers to...more

The AHA’s Letter to Santa Claus

Akerman LLP - Health Law Rx on 1/10/2017

The American Hospital Association, after having been “nice” all year, penned its letter to Santa Claus with its wish list for Christmas. Its four page letter (actually addressed to President-Elect Donald Trump at 1717...more

OIG Delivers Home Care a One – Two Punch: Release of Report and Alert on Home Health Fraud Highlights Increased OIG Scrutiny of...

Cadwalader, Wickersham & Taft LLP on 6/30/2016

On June 22, 2016, the Office of Inspector General (“OIG”) issued two communications that underscore its continued focus on fraud in home health care, along with the role of physicians as “gate keepers” in authorizing...more

OIG Issues Advisory Opinion No. 15-12: Free Home Health Provider Visits Do Not Violate Anti-Kickback Statute

Obermayer Rebmann Maxwell & Hippel LLP on 9/2/2015

The Department of Health and Human Services Office of Inspector General (“OIG”) recently issued a new advisory opinion finding that free introductory visits (the “Introductory Visits”) for patients offered by a home health...more

Can an Arbitrator Rule Against a Hospital for Not Violating the Anti-Kickback Statute?

Faegre Drinker Biddle & Reath LLP on 2/17/2015

Here’s a nightmare. An arbitrator rules against your hospital for failing to honor an agreement to refer Medicare patients to a home health agency. Why? Because the home health agency paid your hospital good money for the...more

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Anti-Kickback Statute › Home Health Agencies

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