News & Analysis as of

Audits Reimbursements

Health Care Compliance Association (HCCA)

[Event] Healthcare Basic Compliance Academy - July 21st - 24th, Nashville, TN

Grounded in the OIG’s General Compliance Program Guidance and DOJ’s Evaluation of Corporate Compliance Programs, our immersive, three-and-a-half-day, classroom-style Healthcare Basic Compliance Academy equips compliance...more

Health Care Compliance Association (HCCA)

[Event] Healthcare Basic Compliance Academy - June 9th - 12th, Pittsburgh, PA

Ideal for practitioners who want to build strong foundational knowledge of compliance program management in a healthcare setting and how to apply that knowledge in practice. Attendees will come away better prepared to...more

McDermott Will & Emery

CMS Poised for Medicare, Medicaid Integrity Enforcement Actions

McDermott Will & Emery on

The Trump administration and 119th Congress are preparing to reduce federal expenditures by targeting Medicare and Medicaid fraud, waste, and abuse. Medicare enrollment revocations, Medicaid enrollment terminations, and...more

J.S. Held

Inside the Healthcare Industry: The Critical Role of Medical Coding, Billing & Nurse Review

J.S. Held on

In what is already a highly regulated industry, it is becoming increasingly difficult for healthcare organizations to navigate the growing volume, complexity and enforcement of laws, regulations and guidance that surround...more

King & Spalding

OIG Releases Findings on Medicare Contractor Compliance with Medicare Cost Report Oversight Requirements

King & Spalding on

Last week, OIG’s Office of Audit Services released its latest report on Medicare Administrative Contractors’ (MACs) compliance with Medicare cost report oversight requirements. The report, which is titled Medicare...more

Health Care Compliance Association (HCCA)

[Event] Healthcare Basic Compliance Academy - March 24th - 27th, Chicago, IL

Ideal for practitioners who want to build strong foundational knowledge of compliance program management in a healthcare setting and how to apply that knowledge in practice. Attendees will come away better prepared to...more

Kerr Russell

The Difference Between ‘Non-Covered’ vs. ‘Disallowed’ Services

Kerr Russell on

Question: I have had several colleagues describe their experience with dental plan audits. All of them have had to pay something back. Sometimes they say this is due to a service being deemed a “noncovered service.” Other...more

Health Care Compliance Association (HCCA)

[Event] Healthcare Basic Compliance Academy - January 27th - 30th, Orlando, FL

Ideal for practitioners who want to build strong foundational knowledge of compliance program management in a healthcare setting and how to apply that knowledge in practice. Attendees will come away better prepared to...more

Health Care Compliance Association (HCCA)

[Event] Healthcare Basic Compliance Academy - December 9th - 12th, San Diego, CA

Ideal for practitioners who want to build strong foundational knowledge of compliance program management in a healthcare setting and how to apply that knowledge in practice. Attendees will come away better prepared to...more

Health Care Compliance Association (HCCA)

[Event] Healthcare Basic Compliance Academy - November 18th - 21st, Boston, MA

Ideal for practitioners who want to build strong foundational knowledge of compliance program management in a healthcare setting and how to apply that knowledge in practice. Attendees will come away better prepared to...more

Health Care Compliance Association (HCCA)

[Event] Healthcare Basic Compliance Academy - August 19th - 22nd, Washington, DC

This three-and-a-half-day, classroom-style learning experience is designed for compliance professionals ready to advance their career by mastering the fundamentals of compliance program management in a healthcare setting....more

Health Care Compliance Association (HCCA)

[Event] Basic Healthcare Compliance Academy - July 15th - 18th, Charlotte, NC

Designed for professionals with some compliance knowledge and experience, HCCA’s Healthcare Basic Compliance Academy is ideal for practitioners who are ready to support, enhance, and oversee a comprehensive compliance program...more

King & Spalding

PCAOB Division of Enforcement’s First Quarter Continues Record-Setting Pace

King & Spalding on

The PCAOB’s Division of Enforcement and Investigations’ 2024 first quarter activity continued the blistering pace of enforcement since Erica Williams became the Board’s Chair. While the Board’s first quarter enforcement...more

Health Care Compliance Association (HCCA)

[Event] Healthcare Basic Compliance Academy - July 15th - 18th, Charlotte, NC

Designed for professionals with some compliance knowledge and experience, HCCA’s Healthcare Basic Compliance Academy is ideal for practitioners who are ready to support, enhance, and oversee a comprehensive compliance program...more

Health Care Compliance Association (HCCA)

[Event] Healthcare Basic Compliance Academy - June 3rd - 6th, New Orleans, LA

Designed for professionals with some compliance knowledge and experience, HCCA’s Healthcare Basic Compliance Academy is ideal for practitioners who are ready to support, enhance, and oversee a comprehensive compliance program...more

Proskauer - Health Care Law Brief

NYS DFS Revisits PBM Regulation with Scaled-Back Draft Rules

On February 6, 2024, the New York State Department of Financial Services (“DFS”) released “pre-proposed” consolidated rulemaking related to the business practices of Pharmacy Benefit Managers (“PBMs”) licensed to operate in...more

Health Care Compliance Association (HCCA)

[Event] Healthcare Basic Compliance Academy - March 11th - 14th, Nashville, TN

Designed for professionals with some compliance knowledge and experience, HCCA’s Healthcare Basic Compliance Academy is ideal for practitioners who are ready to support, enhance, and oversee a comprehensive compliance program...more

King & Spalding

CMS Publishes Final Rule Regarding CMPs for Late Reporting by Medicare Secondary Payers

King & Spalding on

On October 11, 2023, CMS published a final rule (the Final Rule) regarding how and when CMS will impose civil monetary penalties (CMPs) for Medicare secondary payers (MSPs) that untimely report required information. The Final...more

Stevens & Lee

False Claims Act’s Materiality Requirement Spotlighted Again in Recently-Decided Third Circuit Case

Stevens & Lee on

The False Claims Act’s (FCA) materiality requirement as articulated by the U.S. Supreme Court in Universal Health Servs., Inc. v. United States ex rel. Escobar, 579 U.S. 176 (2016) was again front and center, this time in a...more

Health Care Compliance Association (HCCA)

[Event] Healthcare Basic Compliance Academy - December 11th - 14th, Orlando, FL

Designed for professionals with some compliance knowledge and experience, HCCA’s Healthcare Basic Compliance Academy is ideal for practitioners who are ready to support, enhance, and oversee a comprehensive compliance program...more

Health Care Compliance Association (HCCA)

[Event] Healthcare Basic Compliance Academy - November 13th - 16th, Denver, CO

Designed for professionals with some compliance knowledge and experience, HCCA’s Healthcare Basic Compliance Academy is ideal for practitioners who are ready to support, enhance, and oversee a comprehensive compliance program...more

Arnall Golden Gregory LLP

AGG Talks: Home Health & Hospice - Reimbursement Audits and Appeals

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

Health Care Compliance Association (HCCA)

[Event] Healthcare Basic Compliance Academy - October 16th - 19th, San Francisco, CA

HCCA’s Healthcare Basic Compliance Academy provides three-and-a-half-days of classroom-style learning that addresses methods for implementing and managing compliance programs based on the Seven Element Approach. Academies...more

Epstein Becker & Green

Local Law Amends New York City Charter and Establishes an Office of Healthcare Accountability

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

Health Care Compliance Association (HCCA)

[Event] Healthcare Basic Compliance Academy - September 11th - 14th, Boston, MA

Designed for professionals with some compliance knowledge and experience, HCCA’s Healthcare Basic Compliance Academy is ideal for practitioners who are ready to support, enhance, and oversee a comprehensive compliance program...more

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