News & Analysis as of

Final Rules Healthcare Fraud

Proskauer - Health Care Law Brief

CMS Proposes Additional Modifications to the Overpayment Rule Relating to the Deadline for Reporting and Returning Overpayments

In the context of Medicare Advantage (“MA”) reform initiatives, we previously addressed the Centers for Medicare & Medicaid Services’ (“CMS”) December 27, 2022 proposal to amend its regulations set forth at 42 C.F.R. §...more

American Conference Institute (ACI)

[Event] 15th Annual Advanced Forum on Managed Care Disputes and Litigation - May 2nd - 3rd, Chicago, IL

ACI’s Advanced Forum on Managed Care Disputes and Litigation offers an unparalleled learning experience, specifically designed for the MCO legal community. Attend and develop winning legal strategies and business best...more

McDermott Will & Emery

Healthcare Regulatory Check-Up Newsletter | November 2023 Recap

McDermott Will & Emery on

This issue of McDermott’s Healthcare Regulatory Check-Up highlights regulatory activity for November 2023. We discuss several US Department of Health and Human Services (HHS) agency actions, including the new General...more

McGuireWoods Consulting

Washington Healthcare Update - April 2022 #3

This Week in Washington: White House Releases National Drug Control Strategy...more

Proskauer - Health Care Law Brief

OIG Removes Barrier to Requests for and Issuances of Advisory Opinions When the Same Conduct is Under Investigation

On January 11, 2022, the Office of Inspector General (OIG) for the Department of Health and Human Services (HHS) issued, without an opportunity for public notice and comment, a Final Rule, amending its internal process for...more

Manatt, Phelps & Phillips, LLP

OIG Quietly Revises Bases for Rejecting Advisory Opinion Requests

Responding to industry stakeholder sentiment, the Office of Inspector General (OIG) for the U.S. Department of Health & Human Services (HHS) recently issued an unexpected final rule that, effective February 10, 2022, will...more

Health Care Compliance Association (HCCA)

[Event] Chicago Regional Healthcare Compliance Conference - October 22nd, Chicago, IL

Our one-day Regional Compliance Conferences provide attendees with a forum to interact with local compliance professionals, share information about your compliance successes and challenges, and create educational...more

ArentFox Schiff

Investigations Newsletter: Individual Prosecutions Down But Corporate Resolutions Steady for DOJ’s Fraud Section in 2020, with...

ArentFox Schiff on

Individual Prosecutions Down But Corporate Resolutions Steady for DOJ’s Fraud Section in 2020, with More in the Pipeline - The Department of Justice’s (“DOJ”) Fraud Section recently released a year-in-review report that...more

ArentFox Schiff

What Should Pharma Companies Expect From the Biden Administration?

ArentFox Schiff on

With the change of administrations typically comes a flurry of activity across all government agencies, and the same can be expected with the official start of the Biden Administration now well underway. What should...more

Manatt, Phelps & Phillips, LLP

[Webinar] Unpacking the Anti-Kickback and Stark Reforms: Promoting Value-Based Care and Easing Regulatory Compliance - January...

A New Manatt Webinar Guides You Through New Reforms Promoting Value-Based Care and Easing Regulatory Compliance—the Most Significant Changes to the Federal Fraud and Abuse Landscape in the Last Decade. On November 20,...more

Bricker Graydon LLP

[Webinar] Stark Law and Anti-Kickback Statute Final Rules – Exploring the major changes to fraud and abuse laws - December 14th,...

Bricker Graydon LLP on

On November 20, 2020, the Centers for Medicare and Medicaid Services and the Department of Health and Human Services Office of Inspector General issued highly anticipated final rules to reform fraud and abuse law for the...more

Bricker Graydon LLP

[Webinar] Stark Law and Anti-Kickback Statute Final Rules – Exploring the major changes to fraud and abuse laws - December 7th,...

Bricker Graydon LLP on

On November 20, 2020, the Centers for Medicare and Medicaid Services and the Department of Health and Human Services Office of Inspector General issued highly anticipated final rules to reform fraud and abuse law for the...more

Robinson+Cole Health Law Diagnosis

CMS Extends Timeline for Finalizing Changes to Physician Self-Referral (Stark) Law Regulations to August 2021

On August 24, 2020, the Centers for Medicare & Medicaid Services (CMS) announced an “extension of the timeline” for publication of a final rule addressing changes to the Physician Self-Referral Law (or Stark Law) regulations....more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 29, Number 3. News Briefs: January 2020 #3

Report on Medicare Compliance 29, no. 3 (January 27, 2020) - Mission, Texas, rheumatologist Jorge Zamora-Quezada, M.D., was found guilty by a jury Jan. 15 for his part in a $325 million heath fraud scheme in which he...more

Sheppard Mullin Richter & Hampton LLP

CMS Finalizes Rule Expanding its Authority to Deny and Revoke Medicare Program Enrollment, Among Other Changes

On September 5, 2019, the Centers for Medicare and Medicaid Services (“CMS”) released a final rule with comment period entitled, “Program Integrity Enhancements to the Provider Enrollment Process” (the “Final Rule”). The...more

Sheppard Mullin Richter & Hampton LLP

New OIG Exclusion Authority Rule Set To Go Into Effect on March 21, 2017

On January 12, 2017, just a week prior to President Trump’s Inauguration, the Department of Health and Human Service (HHS) Office of Inspector General (OIG) published a final Rule (Rule) regarding one of its most important...more

Baker Donelson

Federal Agencies Forced to Implement Huge Increases in Civil Monetary Penalties for Health Care Fraud

Baker Donelson on

Thanks to section 701 of the Bipartisan Budget Act of 2015, Public Law 114–74, federal agencies have been forced to implement huge increases in penalties intended to deter health care fraud. The Federal Civil Penalties...more

Foley & Lardner LLP

CMS Issues Final Rule on ACOs Participating in the Medicare Shared Savings Program

Foley & Lardner LLP on

The Centers for Medicare & Medicaid Services (“CMS”) issued a final rule (the “Final Rule”) for accountable care organizations (“ACOs”) participating in the Medicare Shared Savings Program (“MSSP”) on June 6, 2016. In the...more

Baker Donelson

Limited Modifications in Final ACO Fraud and Abuse Waivers Most Notably Include Cut of Gainsharing CMP Waiver

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Nearly four years after publishing their joint interim final rule with comment period, effective November 2, 2011 (IFC), the OIG and CMS (Agencies) have finalized the waivers of various fraud and abuse laws in the context of...more

Saul Ewing Arnstein & Lehr LLP

CMS and OIG Issue Final ACO Waivers

On Thursday, October 29, 2015, the Centers for Medicare & Medicaid Services (“CMS”) and the Office of Inspector General (“OIG”) jointly issued a rule (the “Final Rule”) to finalize five (5) waivers of certain fraud and abuse...more

Mintz - Health Care Viewpoints

Skeletons in the Closet? Beware of Potential Enforcement Actions

With Halloween looming, a discussion of skeletons that may be lurking in a health care provider’s closet is timely. Many of our previous posts, as well as the monthly Qui Tam Updates published by our Health Care Enforcement...more

King & Spalding

New CMS Enrollment Rules Strengthen Oversight of Medicare Providers

King & Spalding on

On December 5, 2014, CMS published a final rule to strengthen its oversight of Medicare providers. The rule includes safeguards designed to prevent providers with unpaid debt from re-entering Medicare and to remove providers...more

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