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Healthcare Fraud Medicaid Centers for Medicare & Medicaid Services (CMS)

Foley & Lardner LLP

Health Care Enforcement: “Tea Leaves” in the 2024 National Health Care Fraud Summer Takedown

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Each summer in recent years, the U.S. Department of Justice (DOJ) and associated fraud enforcement partners have indicted many health care defendants, in multiple cases across the country. This summer continued the tradition....more

Benesch

Dental/DSO Intelligence Monthly Report: July/August 2024

Benesch on

Background on Indiana’s “Baby HSR” Law - Indiana passed Senate Bill 9 in March 2024, which requires an Indiana healthcare entity involved in a merger or acquisition with another healthcare entity with a value of at least...more

Stark & Stark

New Jersey’s Nursing Homes: A Closer Look at CMS’s Special Focus Facilities

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In April of 2024, Centers for Medicare & Medicaid Services (CMS) updated their list of Special Focus Facilities. Special Focus Facilities (SFFs) are “nursing homes that have a history of serious quality issues and are...more

Health Care Compliance Association (HCCA)

[Event] Regional Healthcare Compliance Conference - May 9th - 10th, San Juan, Puerto Rico

Looking for compliance education and networking in your area? HCCA’s Regional Healthcare Compliance Conferences offer practitioners convenient, local compliance education on a wide variety of current and emerging topics...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

Foley & Lardner LLP

“Let’s Talk Compliance”: OIG’s General Compliance Program Guidance: How to Refresh Compliance Programs

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Editor’s Note: PYA and Foley & Lardner hosted the 6th Annual “Let’s Talk Compliance” two-day Virtual Conference on January 18 and 19, 2024. Panelists included Foley & Lardner attorneys and PYA experts. The event was hosted by...more

Health Care Compliance Association (HCCA)

[Event] 2024 Managed Care Compliance Conference - January 29th - 30th, Coronado, CA

Explore the unique issues that are pertinent to managed care professionals! This annual event dedicated to compliance management for health plan providers is returning to an in-person format for 2024. Join your peers and...more

Health Care Compliance Association (HCCA)

[Event] 2023 Healthcare Enforcement Compliance Conference - November 5th - 7th, Washington, DC

Hear directly from the enforcement community - Want to gain insight into properly monitoring, detecting, investigating, and managing violations? Join us at HCCA’s Annual Healthcare Enforcement Compliance Conference to...more

BCLP

U.S. Health Care Industry Takes Note: U.S. Supreme Court 2023 Attention on False Claims Act

BCLP on

This Tuesday, April 18, 2023, the U.S. Supreme Court heard argument in U.S. v. SuperValu. SuperValu is the second – and more consequential – False Claims Act (FCA) case of the term....more

ArentFox Schiff

Investigations Newsletter: Nurse Pleads Guilty to Health Care Fraud, Distributing Controlled Substances

ArentFox Schiff on

Nurse Pleads Guilty to Health Care Fraud, Distributing Controlled Substances - On May 9, 2023, an advanced practice registered nurse pleaded guilty to unlawfully distributing controlled substances and committing health...more

Bradley Arant Boult Cummings LLP

Key Insights from DOJ’s False Claims Act Statistics for Fiscal Year 2022

The Department of Justice (DOJ) released its annual summary of False Claims Act (FCA) recoveries for the prior fiscal year, and the data points to a number of notable trends. Although DOJ brought in the second-highest...more

Fox Rothschild LLP

Five Differences Between the Federal Anti-Kickback Statute and the Federal Stark Law

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Physicians around the country are familiar with the Federal Anti-Kickback Statute (“AKS”) (42 U.S.C. § 1320a-7b(b)) and the Federal Physician Self-Referral Law, commonly referred to as the Stark Law (“Stark”) (42 U.S.C. §...more

Health Care Compliance Association (HCCA)

[Virtual Event] 2023 Managed Care Compliance Conference - January 31st - February 2nd, 8:25 am - 3:15 pm CT

Join us for our annual event dedicated to compliance management for health plan providers. Learn the latest best practices and emerging trends from industry leaders while making connections with peers and mentors who...more

Health Care Compliance Association (HCCA)

[Virtual Event] Healthcare Enforcement Compliance Conference - November 7th - 9th, 8:55 am - 3:30 pm CST

Hear directly from the enforcement community - Want to gain insight into properly monitoring, detecting, investigating, and managing violations? Join us virtually at HCCA’s Annual Healthcare Enforcement Compliance...more

McGuireWoods Consulting

Washington Healthcare Update - April 2022 #3

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

Burr & Forman

Health Care E-Note - November 2021

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Helpful hints - OIG Updates Health Care Fraud Self-Disclosure Protocol (“SDP”)  - On November 8, 2021, the OIG issued an updated SDP to providers, which included clarifications of existing guidance and increased the minimum...more

Sheppard Mullin Richter & Hampton LLP

HHS OIG Studies State Medicaid Programs’ Use of Telehealth

The United States Department of Health and Human Services Office of Inspector General (“OIG”) recently issued a report concerning the use of telehealth to render behavioral health services to Medicaid enrollees, calling for...more

Goodwin

OIG Advocates for Increased Oversight of Medicaid Telehealth Services in Behavioral Health

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Telehealth’s exponential growth –in part due to the COVID-19 pandemic – has highlighted both its value in increasing access to care and the potential for misuse. The U.S. Department of Health and Human Services’ Office of...more

Oberheiden P.C.

Federal Government Targets Providers Administering Amniotic Injections

Oberheiden P.C. on

The federal government has recently made clear its intention to go after healthcare providers who provide amniotic injections to certain Medicare and Medicaid recipients. Over recent years, the federal government has...more

Health Care Compliance Association (HCCA)

[Event] 2022 Managed Care Compliance Conference - January 30th - February 1st, Phoenix, AZ

Attend our annual event for those who manage compliance at health plan providers. Explore topics and issues that are pertinent to industry professionals like you. Learn the latest practices, share strategies, and connect with...more

Oberheiden P.C.

Seven Points to be Aware of for Durable Medical Equipment Company Compliance

Oberheiden P.C. on

Durable medical equipment (DME) is particularly important for many Medicare beneficiaries. However, companies that manufacture and sell DME need to be careful because there are strict federal regulations outlining almost...more

King & Spalding

OIG Releases Semiannual Report to Congress

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On May 28, 2021, OIG released its Semiannual Report to Congress (the Report). The Report describes OIG’s work during the 6-month semiannual reporting period of October 1, 2020, through March 31, 2021 (the Semiannual Reporting...more

McDermott Will & Emery

DOJ and HHS-OIG Ramp Up COVID-Related Healthcare Fraud Enforcement Activity

Since the outset of the COVID-19 pandemic, the US Department of Justice (DOJ) has prioritized identifying and prosecuting COVID-related fraudulent conduct, including healthcare fraud. Most of the DOJ’s enforcement activity to...more

ArentFox Schiff

Investigations Newsletter: Court Rules Prescription Drug Event and Enrollee Encounter Data Are 'Claims for Payment' Under the...

ArentFox Schiff on

Court Rules Prescription Drug Event and Enrollee Encounter Data Are 'Claims for Payment' Under the False Claims Act - US District Judge Noel L. Hillman approved a whistleblower’s request to file a Fourth Amended Complaint...more

Health Care Compliance Association (HCCA)

[Virtual Event] 2021 Managed Care Compliance Conference - February 1st - 3rd, 9:30 am - 3:45 pm CST

The first ever VIRTUAL Managed Care Compliance Conference will have the great speakers and content you have come to expect from the in-person event. Each year, we look forward to hosting compliance professionals at our...more

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