5 Key Takeaways | 2024 Emerging Trends: Delaware Unclaimed Property VDA and Multistate Audits
Common Scenarios Triggering False Claims Act Violations, Part 3: Claims and Investigations
Compliance Tip of the Day: Machine Learning for Internal Audit
DE Under 3: OFCCP Changes Up Important Technical Details of its Audit Selection Process in First FY 2024 CSAL
Preparing for a Government Healthcare Audit
What Can A Tax Attorney Do For You? A Podcast With Janathan Allen
Navigating GSA Audits Compliance Strategies and Best Practices
DE Under 3: US DOL Inspector General’s Office Plans to Review Effectiveness of OFCCP Compliance Evaluations
DE Under 3: What Federal Contractors Need to Know About OFCCP's New Audit Scheduling Letter
DE Under 3: What’s New in OFCCP’s Latest Audit Scheduling Letter for Supply & Service Contractors
Independent Audits of Nonprofit Organizations With Douglas Cook
DE Under 3: U.S. OPM Proposed Allowing Federal Managers To Avoid Most Qualified Candidates To Pick Those Who Offer Better “Fit”
AGG Talks: Home Health & Hospice - Reimbursement Audits and Appeals
After ALJ: Options and Opportunities in the Face of an Unfavorable ALJ Decision
The Presumption of Innocence Podcast: Episode 21 - Conservation Easement Donations: Tax Shelter or Charitable Contribution Deduction?
Compliance and Managing from the Middle
I Understood There Would Be No Math: Audits, Extrapolations, and a New Set of Rules
JONES DAY PRESENTS®: Trade Secret Audits: Enhanced Mapping, Protecting Access and Creating Understanding
Constangy Webinar - DEI Audits: Tools to Enhance Your DEI Practices
[Podcast] New Year, New PAC: Have a Successful PAC Audit in 2023
In a recent audit, the Centers for Medicare & Medicaid Services (“CMS”) uncovered non-compliance by Aetna Health Inc. of Texas (“Aetna”) in calculating key payment information for air ambulance services under the No Surprises...more
Although most health care lawyers and compliance officers who review and analyze physician compensation understand that fair market value (FMV) is important, the nuances around FMV are sometimes missed....more
The Audit Process - While Medicaid audits are meant to ensure integrity and efficiency of the Medicaid Program, they can often be incredibly cumbersome and challenging for medical providers to navigate. During an audit,...more
In recent testimony before the United States House Committee on Energy and Commerce Subcommittee on Oversight and Investigations, Christi A. Grimm, Inspector General of the Department of Health and Human Services (HHS)...more
Historically, the Centers for Medicare and Medicaid Services (“CMS”) has not aggressively pursued enforcement activity under the Sunshine Act. However, this may change in 2024. Late last year, CMS updated its Open Payments...more
On February 28, 2024, President Biden signed Executive Order 14117 (the EO), on “Preventing Access to Americans’ Bulk Sensitive Personal Data and United States Government-Related Data by Countries of Concern.” The United...more
Audits are an important part of a compliance program and help monitor compliance obligations, identify non-compliance, and quantify overpayments. But, planning the audit is often just as important as the audit itself. One of...more
With the end of the first quarter of 2024, we highlight five developments, changes, or challenges that health systems, hospitals, nursing homes, clinics, physician practices, health insurers, and other health care providers,...more
Spring is a time for renewal. Cleaning out your home, refreshing your life and at work, reassessing your compliance program to ensure that it is operating effectively and efficiently. As federal and state governments continue...more
HRSA’s “Audit Reporting Requirement Attestations” arrived in inboxes on Friday, March 22, 2024, and require a response by Friday, April 5, 2024. The government is under pressure to show that the money distributed under the...more
2024 is shaping up to be a very active year for regulatory and enforcement developments in the healthcare industry – developments that concern not just hospitals and nursing facilities, but many non-healthcare companies as...more
The U.S. Department of Health and Human Services Office of Inspector General (HHS OIG) released an important new compliance resource in November 2023. The HHS OIG’s new General Compliance Program Guidance (GCPG) is intended...more
As we reported in early 2023, several states have passed pay transparency laws that require certain disclosures in job postings (both internally and externally). That trend has continued, with states like Illinois joining the...more
We’re back from the holidays with updates on 340B litigation to help you stay in the know on how 340B cases are developing across the country as we move into 2024. Each week we comb through the dockets of more than 50 340B...more
Report on Research Compliance 20, no. 12 (December 2023) Although the National Science Foundation (NSF) allowed more than half the costs questioned by auditors for its Office of Inspector General (OIG), the California...more
On November 3, a federal district court issued a monumental decision endorsing an expansive view of who is a “patient” of a 340B program covered entity eligible to receive a 340B drug. In Genesis Healthcare, Inc. v. Becerra,...more
On March 20, 2018, the United States Supreme Court decided Cyan, Inc. v. Beaver County Employees Retirement Fund, in which it unanimously held that the Securities Litigation Uniform Standards Act of 1998 does not strip state...more
In this episode, Jason Bring, AGG Healthcare partner and co-chair of the Post-Acute & Long-Term Care team, and Lanchi Nguyen Bombalier, AGG Healthcare partner and member of the Post-Acute & Long-Term Care, Hospitals & Health...more
The US Department of Health and Human Services Office for Civil Rights (OCR) recently announced a settlement with a community hospital resolving an investigation under the Health Insurance Portability and Accountability Act...more
On June 8, 2023, the New York City Council passed a bill focused on healthcare accountability, with the goal of increasing access to healthcare services for New Yorkers. Entitled the Healthcare Accountability & Consumer...more
OIG released its Semiannual Report to Congress (the Report) which summarizes the agency’s activities from October 1, 2022, through March 31, 2023 (the Reporting Period). Among other accomplishments, the Report highlights...more
Summary - The Department of Health and Human Services Office of Inspector General (HHS OIG) has announced its intention to comprehensively review nursing home citations issued by the Centers for Medicare and Medicaid...more
More than four years after it was proposed, on February 1, 2023 the Centers for Medicare & Medicaid Services (CMS) published the long-awaited risk adjustment data validation (RADV) Final Rule (Final Rule) that will affect...more
On January 30, 2023, CMS posted for inspection a final rule describing its Risk Adjustment Data Validation audit methodology (the Final RADV Rule). As we have discussed in prior alerts, the finalization of the RADV Rule,...more
Every Medicare provider should understand the Medicare administrative appeals process. Providers are entitled to be reimbursed for their services and want to keep those reimbursements safe from audits. However, if Medicare...more