OIG Wants Input on Changes to Anti-kickback Statute and CMP

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The U.S. Department of Health and Human Services Office of the Inspector General is looking for ways to encourage and incentivize coordinated care, without violating the Anti-kickback Statute and Civil Monetary Penalties Law. The CMP imposes penalties against those who offer or transfer remuneration to a Medicare or state healthcare program beneficiary to influence the…

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CMS looks to formalize six-year lookback period for Medicare self-referral disclosures

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The Centers for Medicare and Medicaid recently published a notice proposing revisions to its self-referral disclosure protocol (SRDP). The SRDP allows healthcare providers and suppliers to self-disclose actual or potential violations of the physician self-referral statute, or Stark Law. Under the proposal, healthcare providers who use the SRDP will have to provide the agency with…

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TRICARE Billing Scandal Intensifies as Feds Target More Compounding Pharmacies

A mortar and pestle with some pills in the background

Allegations of fraudulent billing practices involving compounding pharmacies and specialty creams is rearing its ugly head again. Now, the U.S. Department of Justice is investigating what is suspected to be half a billion dollars in healthcare fraud linked to these creams used to treat pain. TRICARE, the health insurance program for members of the U.S.…

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