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Federal Health IT Officials Outline Five-Year Plan

The Department of Health and Human Services, led by the Office of the National Coordinator for Health Information Technology (ONC), recently released its 2020-2025 Federal Health IT Strategic Plan for public comment. The 28-page plan outlines goals and objectives to ensure that patients have access to their electronic health information (EHR) that allows them to, […]

OIG Issues Advisory Opinion on Hospital Training Facility

On January 13, the Office of Inspector General (OIG) posted an advisory opinion in which it approved a hospital’s request to provide discounted training to a fire department’s personnel at the hospital’s facility. The hospital asked the government watchdog whether such an arrangement would constitute grounds for the imposition of sanctions under the exclusion authority […]

DOJ Recovers $2.6B in Healthcare Fraud Settlements, Judgments in 2019

The federal government said it was making healthcare fraud a priority, and from the numbers just released by the U.S. Department of Justice, it appears to be bearing fruit. The DOJ announced last week that it recovered more than $3 billion in settlements and judgments from civil cases involving fraud and false claims in the […]

Pharma Giant to Pay $54M to Settle Whistleblower Complaint

Teva Pharmaceuticals earlier this month agreed to pay $54 million to settle a whistleblower lawsuit brought against it by two former sales representatives. Charles Arnstein and Hossam Senousy filed suit against the Israeli-based pharmaceutical company alleging it paid speaker fees to neurologists for participation in “sham” speaker programs in exchange for their prescribing the multiple […]

Proposed Controlled Substance Legislation Aimed at Pharmacies

A group of bipartisan lawmakers is looking to add more ammunition to existing laws designed to identify, report and prevent the distribution of “suspicious orders of controlled substances.” Senators Dianne Feinstein, Chuck Grassley, Shelley Moore Capito and Dick Durbin recently introduced the Preventing Pill Mills Through Data Sharing Act, a bill that would, for the […]

OCR Cracking Down on Providers Who Violate HIPAA’s Right of Access Requirement

HIPAA Privacy Rule’s right of access requires healthcare providers to give patients access to their health records upon request and for a reasonable fee. However, many providers are either slow to respond, fail to respond, or when they do respond, have charged excessive amounts of money for those records. Although many providers have gotten away […]

Lawmakers Want Increased Oversight of Patient Assistance Charities

Concerned that some drugmakers may be using patient assistance charities to pay kickbacks to Medicare beneficiaries as a way to get them to use their drugs, two U.S. lawmakers are urging the U.S. Department of Health and Human Services to increase its oversight. Massachusetts Sen. and presidential candidate Elizabeth Warren, and Sen. Sheldon Whitehouse of […]

OIG Doubles Healthcare Fraud Recoveries in 2019

If it seemed like the government was cracking down extra hard on healthcare fraud this year, it was. According to a recently released report from the Office of Inspector General (OIG), the watchdog agency expects to recover $5.9 billion as a result of healthcare fraud investigations in 2019. That’s nearly double the amount it recovered […]

Whistleblower Protections: Is it Worth the Risk?

There has been a great deal in the news lately about whistleblowers. Specifically, the whistleblower who triggered the impeachment investigation into President Donald Trump. Since the whistleblower filed his or her nine-page memo outlining information received from “multiple sources” that the president was “using the power of his office to solicit interference from a foreign […]

Crackdown on Sober Homes Nets Three

Three South Florida residents are the latest to be convicted in an ongoing crackdown against sober home fraud. Last week, the U.S. Attorney’s Office for the Southern District of Florida announced that Ali Ahmed, 38, Hector Efrain Alvarez, 49, and Mauren Morel, 45, all of Broward and Palm Beach Counties, pleaded guilty to one count […]

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