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Proposed Changes to Stark and Anti-Kickback Laws

The U.S. Department of Health and Human Services Office of the Inspector General, in conjunction with the Centers for Medicare & Medicaid Services, has unveiled long-awaited proposals to revise safe harbor protections under the federal anti-kickback statute for certain coordinated care and associated value-based arrangements. The proposed new regulations also would add protections under the […]

Lying on Financial Disclosure Statements Can Land You in Jail

A Florida businessman who was already serving 57 months in prison on charges of tax and bank fraud, now faces another five years behind bars for making false statements on a financial disclosure statement that he was required to submit to the government. According to a news release from the U.S. Department of Justice, Casey […]

A September to Remember for Healthcare Fraud

To say that federal healthcare fraud investigators have been busy in September would be an understatement. In the last few weeks, nearly 400 people have been implicated in a wide range of healthcare fraud related crimes totaling more than $3 billion. Included in that total are 178 medical professionals. In addition some 50 million in […]

Telemedicine Company Owner, Doctor Plead Guilty in Multimillion-Dollar Fraud

The owner and chief executive of a telemedicine company, along with a New Jersey physician, have pleaded guilty for their roles in one of the largest healthcare schemes ever, that resulted in charges against 24 defendants. On September 6, Lester Stockett pleaded guilty to one count of conspiracy to defraud the U.S. and pay and […]

Watchdog Agency Cracking Down on Improper Billing by HHAs

Last month, the U.S. Department of Health and Human Services Office of the Inspector General issued its latest report on a home health agency that it contends did not comply with Medicare billing requirements. It was one in a series of actions the watchdog agency has taken this year against HHAs, and part of what […]

DOJ Cites Significant Costs and Burdens on Request to Dismiss Qui Tam Case

The Department of Justice has once again exercised its authority under the False Claims Act in seeking the dismissal of a relator’s qui tam lawsuit. Government attorneys, in their motion to dismiss filed on Aug. 20, told the court that further litigation would result in imposing “significant costs and burdens on the government and waste […]

CMS Program to Give Providers Access to Medicare Patient Data

In an effort to accelerate the transformation of the nation’s healthcare system to one that is value-based, the Centers for Medicare & Medicaid Services (CMS), recently launched the Data at the Point of Care (DPC) pilot program. The pilot program, announced by CMS Administrator Seema Verma during a Blue Button Developer Conference, will give healthcare […]

MedPAC: Eliminate “Incident to” Billing for ARNPs and NPs

If Congress adopts the Medicare Payment Advisory Commission’s (MedPAC), most recent recommendations, “incident to” billing could become a thing of the past for Advanced Registered Nurse Practitioners (ARNPs) and Physician Assistants (PAs). The recommendation to eliminate “incident to” billing for these providers was made in MedPAC’s biennial report issued in June. MedPAC is an independent […]

Healthcare Data Breaches Continue to Break Records

There isn’t a day that goes by that some healthcare organization hasn’t fallen victim to a data breach. Thousands of patients from around the country are having their sensitive and personal healthcare information hijacked one way or another. From phishing emails sent to healthcare company employees, to ransomware attacks, to outright failure to secure patients’ […]

DOJ Intervenes in FCA Lawsuit Filed Against Medical Device Maker

The U.S. Department of Justice has intervened in a whistleblower lawsuit filed against medical device maker Life Spine Inc., along with the company’s founder and its VP for Business Development. The lawsuit alleges that the company paid millions of dollars in kickbacks to surgeons in exchange for using its spinal implants, equipment and other devices. […]

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It is not intended as professional advice and should not be construed as such.