A recently issued federal court opinion confirmed that certain pre-COVID era prescribing restrictions are back in place. In July 2023, a nonprofit advocacy group, Community Oncology Alliance, filed suit against the U.S....more
On June 9, Steven Rodriguez, a former nurse from Long Beach, New York, was sentenced in federal court to 2-1/2 years in prison for selling at least 300 fake COVID-19 vaccination cards. Rodriguez and a co-conspirator from...more
The U.S. Department of Justice (DOJ) announced on April 20 that it has brought criminal charges against 18 defendants across the U.S. for various fraud schemes related to the COVID-19 pandemic. The DOJ seized more than $16...more
As many of our readers are no doubt already aware, the U.S. Department of Health and Human Services announced on February 9 that the COVID-19 public health emergency (PHE) will end on May 11. The announcement gave payers,...more
On January 11, U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra formally renewed the federal COVID-19 public health emergency (PHE) for another 90 days. The PHE, which originally went into effect on...more
On December 23, the U.S. Congress passed the “Consolidated Appropriations Act, 2023,” the omnibus budget bill for fiscal year 2023 (HR 2617). The bill includes several provisions relating to Medicare coverage of telehealth,...more
The American Dental Association (ADA) announced on November 15 that the Centers for Medicare & Medicaid Services (CMS) has agreed to create a new Healthcare Common Procedure Coding System (HCPCS) code G0330 for dental...more
On October 13, U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra formally renewed the federal COVID-19 public health emergency (PHE) for another 90 days....more
On July 20, the U.S. Department of Health and Human Services’ Office of Inspector General (OIG) issued a Special Fraud Alert to caution healthcare practitioners who may wish to enter into arrangements with telehealth...more
7/27/2022
/ Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
False Billing ,
Health Care Providers ,
Healthcare Fraud ,
Kickbacks ,
OIG ,
Physicians ,
Telehealth ,
Unnecessary Medical Procedures
On July 15, U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra formally extended the COVID-19 public health emergency for another 90 days. ...more
On April 20, the U.S. Department of Justice (DOJ) announced criminal charges against 21 people across the country for COVID-19-related frauds. The defendants are accused of over $149 million in false billings to federal...more
4/28/2022
/ CARES Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Counterfeiting ,
Department of Justice (DOJ) ,
False Billing ,
Federal Funding ,
Fraud ,
Kickbacks ,
Medicare ,
National Center for Disaster Fraud (NCDF) ,
Vaccinations
On April 12, Department of Health and Human Services (HHS) Secretary Xavier Becerra extended the COVID-19 public health emergency for another 90 days. The PHE had been scheduled to expire on April 16....more
At the beginning of the COVID-19 pandemic, the Centers for Medicare & Medicaid Services expanded Medicare coverage for telehealth nationwide, as discussed here. The $1.5 trillion omnibus spending bill signed into law by...more
The U.S. Department of Justice (DOJ) announced on March 3 that Ameet Goyal, M.D., a Westchester-based ophthalmologist, was sentenced to 96 months in prison for falsely billing for millions of dollars of upcoded procedures...more
We don’t often cover brand-new proposed legislation on Rivkin Rounds, generally preferring to wait until it’s closer to becoming law. However, two bipartisan bills introduced in Congress last week are worthy of mention....more
2/15/2022
/ Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Electronic Protected Health Information (ePHI) ,
Health Care Providers ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Legislative Agendas ,
Medicare ,
PHI ,
Privacy Laws ,
Proposed Legislation ,
Telehealth
On December 22, the Connecticut Department of Public Health (DPH) announced that it issued an Order temporarily suspending the requirements for state licensure, certification or registration of physicians, nurses, and certain...more
A study recently released by the U.S. Department of Health and Human Services (HHS) found that the number of beneficiaries in the traditional Medicare program who used telehealth increased from 840,000 in 2019 to nearly 52.7...more
Please join us as Rivkin Radler Partner Eric D. Fader provides an overview of changes in the provision of telehealth services and federal and state regulation of them, since the beginning of the COVID-19 pandemic. New rules...more
10/27/2021
/ Continuing Legal Education ,
Coronavirus/COVID-19 ,
Data Privacy ,
Data Security ,
Health Care Providers ,
Healthcare Fraud ,
Medical Billing Codes ,
Medicare ,
New Rules ,
Out of Network Provider ,
Physicians ,
Telehealth ,
Telemedicine ,
Webinars
On September 30, the U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) announced that it issued guidance to clarify that the HIPAA Privacy Rule does not prohibit businesses from asking customers,...more
On September 17, the U.S. Department of Justice (DOJ) announced criminal charges against 138 defendants for alleged healthcare fraud schemes that resulted in $1.4 billion in losses. Those charged included 23 doctors, 19...more
The proposed 2022 Medicare Physician Fee Schedule, released on July 13 by the Centers for Medicare & Medicaid Services (CMS), includes expanded reimbursement for behavioral health services delivered by telehealth, including...more
New York’s State Disaster Emergency declaration, which had been extended through June 24 through a series of Executive Orders by Gov. Andrew Cuomo, has expired. Among many other things, the Executive Orders had removed...more
On May 26, the U.S. Department of Justice (DOJ) announced criminal charges against 14 defendants in six states for participation in healthcare fraud schemes related to the COVID-19 pandemic. The coordinated takedown involved...more
5/27/2021
/ Coronavirus/COVID-19 ,
Department of Justice (DOJ) ,
False Billing ,
Fraud ,
Healthcare Fraud ,
Kickbacks ,
Laboratories ,
Medicare ,
Misappropriation ,
Pharmaceutical Industry ,
Provider Relief Fund ,
Telehealth
In an April 15 notice on its COVID-19 portal, the U.S. Department of Health and Human Services’ Office of Inspector General (OIG) reminded healthcare providers that COVID-19 vaccines must be administered at no out-of-pocket...more
In his 2021 State of the State Address on January 10, New York Governor Andrew Cuomo announced legislation to expand access to telehealth. The proposals will adjust reimbursement incentives to encourage telehealth, relax or...more