Natural disasters, while undoubtedly disruptive and damaging, can serve as powerful catalysts for organizational transformation if approached with foresight and strategic intent. As we’ve explored, successful post-disaster...more
Business leaders and risk managers should always be prepared for the worst. As of October 11, 2023, the United States already experienced 24 separate “billion-dollar” weather and climate disasters in the calendar year,...more
In 2022, the United States experienced 18 separate weather and climate disasters costing at least one billion dollars according to NOAA. In 2023, that number rose to 28 separate billion dollar weather events. The frequency...more
The Office of Inspector General of the U.S. Department of Health and Human Services (OIG) on Nov. 6, 2023, issued new General Compliance Program Guidance (GCPG) as a reference guide for the healthcare compliance community....more
In August 2023, the Office of Inspector General for the Department of Health and Human Services (OIG) announced a new strategic plan to investigate the life cycle of Medicare Advantage and Medicaid managed care contracts from...more
Over the past few years, there has been tightening enforcement and numerous lawsuits driven by the increasingly complex web of federal and state anti-kickback and anti-inducement statutes. In a new CLE-eligible webinar,...more
On July 10, 2023, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule (Proposed Rule) that would (i) include hospices in the 36-month rule ownership transfer restrictions that currently exist for home...more
The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) recently posted the final rule establishing civil monetary penalties (CMPs) for information blocking (IB Enforcement Rule). The Rule...more
No personal services are more important than health care. The use of artificial intelligence (AI), involving machines to perform tasks normally requiring human intelligence, is leading to an expansion of the term “personal.”...more
On May 11, 2023, the U.S. Department of Justice (DOJ) announced the launch of its Puerto Rico and U.S. Virgin Islands (USVI) Environmental Crimes Task Force. This new task force will focus specifically on combating...more
The New York State Office of the Medicaid Inspector General (“OMIG”) conducted three statewide sessions to outline its audit process as it pursues its mission to prevent and detect fraud, waste and abuse in the Medicaid...more
Learning Objectives - The importance of developing investigation standards - How to avoid regency bias when conducting investigations - Presenting your investigation findings to stakeholders (OIG, AG, MFCU, etc.)...more
On December 28, 2022, the New York State Office of the Medicaid Inspector General (OMIG) finalized the proposed rule published on July 13, 2022, that significantly revises the provider and Medicaid managed care organization...more
On January 31, 2023, the New York State Office of the Medicaid Inspector General (OMIG) released three guidance documents to assist Medicaid providers in meeting the requirements of recently adopted regulations governing (i)...more
On the heels of publishing their final regulations, on January 31, the New York Office of the Medicaid Inspector General (OMIG) released a variety of guidance documents addressing compliance programs; self-disclosure; and...more
On the heels of the release of the final regulations on December 28, today, the Office of the Medicaid Inspector General just released guidance on Compliance Programs; Self-Disclosure; and Medicaid Managed Care Fraud, Waste...more
Please join us on February 9 as Partner Bob Hussar and Associates Ashley Algazi and Mary Connolly present on OMIG’s finalized regulations. On December 28th, the Office of Medicaid Inspector General (OMIG) released their...more
On January 9, 2023, the U.S. House of Representatives adopted its rules package for the 118th Congress (“House Rules”) by a vote of 220 to 213. While much attention has been given to the provisions that would significantly...more
Effective Dec. 28, 2022, the Office of the Medicaid Inspector General’s (OMIG) revised Part 521 compliance regulations became effective. First proposed in July 2022 for review and comment, only minor, technical changes to the...more
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
As part of the Federal government’s response to the COVID-19 pandemic, the coverage of telehealth services by Medicare was greatly expanded by CMS through the COVID-19 telehealth waivers. Further expansion of...more
In recent years, U.S. enforcement agencies have signaled that a data-analytics driven compliance program is more than a nice to have, it’s a must-have if companies are going to get more adept at demonstrating the...more
Health care is a highly innovative, lucrative, and regulated industry, which also makes it a highly litigious industry. From a legal perspective, it makes sense for practitioners to pay close attention to trends happening in...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
In the July 13, 2022 issue of the New York State Register, the New York State Office of Medicaid Inspector General (OMIG) published a proposed regulation that it will likely adopt this fall. The proposed regulation will add...more