News & Analysis as of

Medicare Virus Testing

Rivkin Radler LLP

Lab Owner Pleads Guilty in Covid Test Kit Fraud Scheme

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Robert Clark of Pompano Beach, Florida recently pleaded guilty to his role in a Medicare fraud scheme. Clark and his co-conspirators purchased Medicare Beneficiary Identification numbers unlawfully and then billed Medicare...more

Rivkin Radler LLP

NYC Man Pleads Guilty in $3.5 Million COVID-19 Kickback Scheme

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On February 26, David Weathers of the Bronx pleaded guilty in federal court in New Jersey for his role in a COVID-19 kickback conspiracy. The government had charged Weathers with soliciting kickbacks in return for referrals...more

Holland & Knight LLP

No Sunset on the Horizon for EKRA

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Recently, Holland & Knight healthcare attorneys have received questions as to whether the Eliminating Kickback in Recovery Act (EKRA) is still in effect, given the recent expiration of many provisions of the Substance...more

Holland & Knight LLP

Federal Judge Cites Ambiguous Coding Guidance, Vacates Doctor's Healthcare Fraud Conviction

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A federal judge recently exposed weaknesses in the U.S. Department of Justice's (DOJ) criminal healthcare fraud enforcement efforts by vacating a jury's conviction of a prominent Maryland doctor. On Aug. 4, 2023, a federal...more

Harris Beach PLLC

HHS Office of Inspector General Publishes August Work Plan Updates

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In its August 15, 2023, Enforcement listserv notice, the U. S. Department of Health and Human Services Office of Inspector General (“OIG”) published its Work Plan Updates for August. This article will highlight three of the...more

ArentFox Schiff

Investigations Newsletter: Walgreens Medicaid Fraud Case Kicked Back to Trial Court

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Walgreens Medicaid Fraud Case Kicked Back to Trial Court - On August 15, 2023, the US Court of Appeals for the Fourth Circuit issued an opinion reversing a district judge’s dismissal of False Claims Act (FCA) claims...more

ArentFox Schiff

Investigations Newsletter: Government Brings FCA Action Against Laboratory Companies

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Government Brings FCA Action Against Laboratory Companies - On July 18, 2023, the US Department of Justice (DOJ) announced it has filed a complaint against multiple laboratory companies and their owner, Patrick...more

BakerHostetler

Government Scrutiny Expected of Providers That Furnished OTC COVID-19 Tests to Medicare Patients

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In April 2022, CMS announced an initiative to pay for Medicare beneficiaries to receive free OTC COVID-19 test kits. Specifically, Medicare established a demonstration project to pay various eligible healthcare providers to...more

Stevens & Lee

The End of the Public Health Emergency: Updated Guidance

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On February 9, 2023, the U.S. Department of Health and Human Services (“HHS”) announced that the Public Health Emergency (“PHE”) arising from the COVID-19 pandemic, declared under Section 319 of the Public Health Service Act,...more

McDermott Will & Emery

How Employers Should Prepare for the End of the Covid-19 National and Public Health Emergencies

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On January 30, 2023, the Biden administration announced its intention to make final extensions of both the COVID-19 National Emergency (NE) and the COVID-19 Public Health Emergency (PHE) through May 11, 2023, at which point...more

King & Spalding

OIG Publishes Annual Medicare Laboratory Test Spending Report: COVID Tests, Chemistry Tests Drive Largest Annual Increase in...

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On December 19, 2022, OIG released its annual report analyzing Medicare Part B spending on laboratory tests over the past year. According to OIG, Medicare Part B spending on laboratory tests increased 17% from $8.0 billion in...more

ArentFox Schiff

DOJ Brings Charges Against 21 People in $150 Million COVID-19 Fraud Action

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The DOJ announced charges against 21 people across nine federal districts for their alleged role in pandemic-related fraud schemes resulting in over $149 million in false billings to federal programs. This is the largest...more

Womble Bond Dickinson

What to Expect as OIG and CMS Audits Focus on COVID-19 Testing?

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The COVID-19 pandemic has caused an enormous need for testing and has spawned the creation of new labs and specimen collection agencies to (try to) meet that need. In 2020 alone, Medicare spent $1.5 billion on COVID-19 tests....more

Miller Canfield

Public Sector Application of CMS' COVID-19 Health Care Vaccination Rule

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Key Takeaways: ..The Rule only applies to Medicare- or Medicaid-certified facilities and their contractors having contact with patients or staff ..The Rule does not apply to school districts receiving Medicare or...more

ArentFox Schiff

Investigations Newsletter: Lab Owner Pleads Guilty to $6.9 Million Medicare Fraud Scheme Involving Kickbacks and Bribery

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Lab Owner Pleads Guilty to $6.9 Million Medicare Fraud Scheme Involving Kickbacks and Bribery - On January 13, 2022, the Department of Justice (DOJ) announced that a Florida man pled guilty in the Southern District of...more

Ervin Cohen & Jessup LLP

Supreme Court Upholds Vaccine Mandate for Medicare and Medicaid-Certified Providers and Suppliers

On the same day that the United States Supreme Court imposed a stay of enforcement on OSHA’s vaccine mandate for private employers with over 100 employees, the Court ruled that the Centers for Medicare & Medicaid Services...more

Holland & Hart LLP

CMS Vaccine Mandate: New Deadlines

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On January 13, 2022, a divided Supreme Court vacated the injunctions that applied to CMS's vaccine mandate in 24 states, thereby allowing CMS to enforce its mandates in all states except Texas. ...more

Dorsey & Whitney LLP

U.S. Supreme Court Lifts Injunction Against CMS’ Health Care Facility Vaccine Mandate: What Does This Mean for Your Health Care...

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Health care employers are not alone in feeling overwhelmed by the constantly changing legal status of the various federal vaccine mandates. On Thursday afternoon, the Supreme Court made its rulings on two preliminary...more

Williams Mullen

Supreme Court Stays OSHA Vaccine Rule

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The United States Supreme Court blocked the Biden administration from implementing and enforcing its OSHA vaccine-or-test requirements for large, private companies, see here. In a 6-3 majority opinion, the Court found that...more

Foley Hoag LLP

Biden Administration OTC Testing Guidance and FAQs

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The Biden administration has issued guidance and FAQs on mandatory insurance coverage of OTC COVID-19 testing. Effective January 15, 2022, plans are required to cover 8 individual at-home over-the-counter COVID-19 tests per...more

Lasher Holzapfel Sperry & Ebberson PLLC

Two Major Changes Address Living-With-COVID Concerns

A national vaccination mandate directed at employers with more than 100 employees became effective 1/10/2022. Although the U.S. Supreme Court has expedited oral arguments regarding judicial stays facing the mandate, the...more

Ogletree, Deakins, Nash, Smoak & Stewart,...

Supreme Court Hears Oral Argument on OSHA’s COVID-19 Vaccination and Testing Emergency Temporary Standard and CMS Vaccine Rule

On Friday, January 7, 2022, the Supreme Court of the United States heard oral arguments on challenges to the Occupational Safety and Health Administration’s (OSHA) COVID-19 Vaccination and Testing Emergency Temporary Standard...more

Holland & Knight LLP

A Dizzying Map of Federal Vaccination Mandates, Injunctions and Stays

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Keeping track of a dizzying number of injunctions and stays by multiple federal district courts and courts of appeal involving three separate federal COVID-19 vaccination mandates with a couple exceptions is no small task....more

Foley & Lardner LLP

Red Light – Green Light: CMS Vaccination Mandate is On Again in 26 States?

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The CMS vaccine rule -- which applies to the staff of many Medicare- and Medicaid-certified providers such as hospitals, long-term care facilities, home-health agencies, and hospices (“covered entities”), and which has...more

ArentFox Schiff

Investigations Newsletter: Florida Surgeon Who Saved Rapper 50 Cent’s Life Is Sentenced to Seven Years Imprisonment for Fraudulent...

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Florida Surgeon Who Saved Rapper 50 Cent’s Life Is Sentenced to Seven Years Imprisonment for Fraudulent Insurance Billing - In 2000, a Florida doctor, Moses deGraft-Johnson, was one of the surgeons who operated on 50 Cent...more

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