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
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
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
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
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
On July 13, the Office of Medicaid Inspector General (OMIG) published proposed regulations implementing 2020 changes to law relating to provider compliance programs, Medicaid managed care fraud, waste and abuse prevention...more
Hear about the latest in research compliance - Do you want to learn… - How to prepare for upcoming changes in Medicaid? - Ways to build and maintain a better research compliance work plan for your program? - How...more
Telehealth’s exponential growth –in part due to the COVID-19 pandemic – has highlighted both its value in increasing access to care and the potential for misuse. The U.S. Department of Health and Human Services’ Office of...more
CMS recently finalized the most significant changes to enrollment since the 2006 enrollment rules were initially adopted. Overview of the New Rule - In its "Program Integrity Enhancements to the Provider Enrollment...more
This week, I am running a special five-part podcast series, Monitoring in Healthcare. In it, I take a deep dive into healthcare monitoring and how the pro-active use of a healthcare monitor can positively impact all...more
On January 29, 2017, the Centers for Medicare and Medicaid Services (CMS) announced a temporary moratorium on enrolling Part B non-emergency ambulance providers/suppliers and home health agencies, subunits and branch...more
While President Donald Trump made repeal of the Affordable Care Act (ACA) a centerpiece of his 2016 presidential campaign, he offered few details about how he would replace it or address other health care issues. More...more
More active SIUs may mean more scrutiny of Medicaid providers - The Texas Office of Inspector General (OIG) has just completed its first full year of reforms under a new Inspector General. 2017 may reveal whether these...more
On July 29, 2016, CMS announced that it is lifting a temporary moratorium on Medicare Part B, Medicaid, and Children's Health Insurance Program (CHIP) emergency ambulance suppliers, but extending and expanding similar...more
The Office of Inspector General (OIG) recently released its mid-year update of its Fiscal Year Work Plan for 2016. The Work Plan summarizes new and ongoing reviews and activities that the OIG plans to pursue. Not...more
Latest Healthcare False Claims Act Roundup and Top 3 Best Practices to Reduce Exposure - As the legal landscape in healthcare becomes increasingly complex, healthcare companies that receive federal program funds face...more
Marilyn Tavenner received bipartisan support from members of the Senate Committee on Finance in her confirmation hearing to lead the Centers for Medicare and Medicaid Services (CMS) though a full Senate vote is being held up,...more