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King & Spalding

OIG Audit Finds Medicare Overpaid Hospitals an Estimated $79 Million for Enrollees Who Had Received Mechanical Ventilation

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On August 12, 2024, OIG announced the results of an audit of payments made to hospitals for inpatient claims with the Medicare Severity Diagnosis-Related Groups (MS-DRGs) that require ninety-six hours of consecutive...more

Manatt, Phelps & Phillips, LLP

340B Hospitals Sue HRSA for Authorizing Audits of 340B Records

On July 24, two hospitals that participate in the Section 340B drug discount program—Oregon Health & Science University and Maine General Medical Center—filed separate lawsuits against the Health Resources and Services...more

ArentFox Schiff

Fast Five: Important Law and Policy Updates for US Health Care Transactions

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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

NAVEX

Addressing Cybersecurity Expectations in Healthcare

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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

Marshall Dennehey

A Hospital’s Metadata is Subject to Inspection in New Jersey Medical Malpractice Matters

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Key Points: New Jersey’s Appellate Division held that an inspection of a hospital’s electronic medical records, including its metadata, is discoverable despite the risks and burdens of producing such information for review....more

Harris Beach PLLC

HHS OIG Work Plan – December Update – Audits for Medicare Emergency Codes

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In its December 18, 2023, Enforcement listserv notice, HHS’s Office of Inspector General (“OIG”) published its Work Plan Updates for December. Although six updates were published, this article will only highlight the...more

Mintz - Health Care Viewpoints

New York State Prepares to Regulate Hospital Cybersecurity Programs

On November 13, 2023, Governor Kathy Hochul announced plans to regulate cybersecurity for New York general hospitals regulated under Article 28 of the Public Health Law. As proposed, the regulations will provide an additional...more

King & Spalding

OIG Announces Results of Hospital Transfer Payment Policy Audit

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On Friday, October 6, 2023, OIG announced the results of an audit performed on the Medicare Part A hospital transfer policy for discharges to post-acute care (PAC). The hospital transfer policy, which was established in...more

Health Care Compliance Association (HCCA)

OIG: COVID-19 UIP Overpaid Providers $784M; HRSA Will Recoup Money

Hospitals and other providers should brace for recoupment of possibly hundreds of millions of dollars they were reportedly overpaid for services provided under the COVID-19 uninsured program (UIP) in the wake of new audit...more

McDermott Will & Emery

HIPAA Compliance 101: Lessons from a Recent OCR Settlement

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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

Epstein Becker & Green

HRSA Initiates Audits and Requires Return of Provider Relief Funds

Throughout the course of the pandemic, the Health Resources and Services Administration (HRSA) distributed $178 billion in Provider Relief Funds (PRF) to hospitals and health care providers.  The Public Health Emergency has...more

McDermott Will & Emery

HRSA and OIG Begin Recovery and Audits of the COVID-19 Funding Programs

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The Health Resources and Services Administration (HRSA) reminded providers through a program update on Monday, June 5, 2023, that the Provider Relief Fund (PRF) and COVID-19 Uninsured Program (UIP) Terms and Conditions...more

Rivkin Radler LLP

[Webinar] Lunch and Learn Series: Avoiding the Pitfalls in Recent Government Enforcement - December 8th, 12:00 pm - 1:00 pm ET

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Please join us for the December Lunch and Learn with Benjamin Malerba and Benjamin Wisher. The pair will discuss recent audits, investigations and actions of government agencies including DOJ, MFCU, OMIG, the NY AG and...more

Health Care Compliance Association (HCCA)

[Virtual Event] Indianapolis & Pittsburgh Regional Healthcare Compliance Conference - October 7th, 8:25 am - 4:30 pm EDT

General and specialty compliance training from the comfort of your home or office! HCCA’s Regional Healthcare Compliance Conferences provide practitioners with virtual compliance training that includes updates on the...more

Gardner Law

Anti-Fraud & Sunshine Update

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Staying up-to-date with fraud enforcement trends and recent cases and settlements can sometimes be viewed as a “Glass Half Empty” perspective, focusing on negative aspects of the industry and the perceived threat of...more

Health Care Compliance Association (HCCA)

[Event] Regional Healthcare Compliance Conference - July 22nd, Seattle, WA

Looking for compliance training and networking in your area? HCCA’s Regional Healthcare Compliance Conferences offer practitioners convenient, local compliance training, including updates on the latest news in regulatory...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 31, Number 18. News Briefs: May 2022

Report on Medicare Compliance 31 no. 18 (May 16, 2022) - In a new report, the HHS Office of Inspector General (OIG) said 25% of Medicare beneficiaries experienced patient harm (adverse events and temporary harm events)...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 31, Number 14. News Briefs: April 2022

Report on Medicare Compliance 31, no. 14 (April 18, 2022) - Michigan gynecologic oncologist Vinay Malviya, M.D., has agreed to pay $775,000 to settle false claims allegations in connection with medically unnecessary...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 30, Number 28. News Briefs: August 2021

Report on Medicare Compliance 30, no. 28 (August 2, 2021) - CMS has not fined any hospitals yet for noncompliance with price transparency requirements, a spokesperson tells RMC. “In April 2021, CMS began issuing warning...more

Health Care Compliance Association (HCCA)

[Webinar] 2021 Mid-Year OIG Work Plan and Other Important Updates: – Hospitals, Physician Practices, Home Health, and Hospice -...

Learning Objectives: - Discuss OIG work planning process, work plan items, and other government reports - Provider insights into COVID-19 audits, reviews, and monitoring... During this program, we will provide an...more

Bricker Graydon LLP

CMS begins enforcement of Hospital Price Transparency Rule

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The Centers for Medicare and Medicaid Services (CMS) has confirmed that the agency began sending warning letters to hospitals it deems out of compliance with the Hospital Price Transparency Rule in April 2021. This represents...more

Health Care Compliance Association (HCCA)

Report on Research Compliance Volume 18, Number 3. In This Month's E-News: March 2021

Report on Research Compliance 18, no. 3 (March 2021) - ◆ A former post-doctoral fellow at the McGovern Medical School, part of the University of Texas (UT) Health Science Center, admitted to committing research misconduct...more

Bricker Graydon LLP

CMS issues mid-build audit determinations for provider-based locations

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At long last, the Centers for Medicare and Medicaid Services (CMS) has issued decisions on provider applications for the mid-build exception. Nearly four years after the deadline for hospitals to apply for the mid-build...more

K&L Gates LLP

COVID-19: K&L Gates Triage: COVID Audits

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In this week’s episode, Stephen Bittinger discusses the impending resumption of Medicare error-based audits, which were temporarily suspended following the onset of the COVID-19 crisis. Mr. Bittinger discusses the different...more

Health Care Compliance Association (HCCA)

Report on Research Compliance 17, no. 7 In This Month's E-News: July 2020

Report on Research Compliance 17, no. 7 (July 2020) - NIH has opened its “initial data set and tools” in its All of Us research program to investigators under a new beta model that does not allow downloading of...more

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