OIG Proposes New Anti-Kickback Law Safe Harbors
(November 10, 2014): The U.S. Department of Health and Human Services Office of Inspector General (“OIG”) recently published a Proposed Rule that would amend the safe harbor regulations under the Federal Anti-Kickback statute (“AKS”) as well as add new safe harbors. The Proposed Rule would also establish new exceptions to the Civil Monetary Penalty (“CMP”) statute related to the beneficiary inducement CMP. OIG will accept comments on the Proposed Rule by mail or electronically until December 2, 2014 at 5 p.m. (Eastern). I. The Anti-Kickback Statute and Safe Harbor Regulations: The AKS provides criminal penalties for individuals or entities that knowingly and ...
Dental Fraud Settlement — $5.05 Million to be Paid by Oklahoma Dental Practice in Medicaid Case.
(November 10, 2014): Dental fraud investigations and audits are becoming increasingly prevalent throughout the United States. An Oklahoma-based dental practice has recently agreed to pay $5.05 million in civil claims stemming from allegations that the practice committed Medicaid dental fraud, submitting false claims to Medicaid from January 2005 through September 2010. The Oklahoma practice provides dental care to Medicaid-eligible children through multiple clinics located in a number of states. Each dentist draft visit notes that outlines the services performed on each individual patient. The practice then submits claims for reimbursement to the Oklahoma Health Care Authority (OHCA) based on dentists’ documentation. After OHCA ...
HIPAA Risk Assessments are Essential to Avoid Liability: Part II: Risk Analysis
(September 29, 2014) In the last article, we discussed the importance of conducting a risk analysis under the HIPAA Security rules. The importance of promptly conducting a risk analysis if it has not yet done cannot be overestimated, as the HHS Office for Civil Rights (OCR) has now announced that they intend to begin the next phase of audits in October 2014. When Covered Entity receives a data request letter from OCR, it will have only two weeks to respond, which will not be enough time to conduct a risk analysis at that point. In this article we’ll discuss eight elements ...
Medicare Termination / Medicare Revocation Cases: Tips for Avoiding & Steps for Appealing.
(September 16, 2014): Consider the following scenario. You own a durable medical equipment (DME) company that you run out of a leased location in a local office building. Your customers are a mix of privately insured and Medicare/Medicaid beneficiaries. You've been in business for about 10 years, but money is tight and you need to reduce expenses. You decide to move your business to your home for the time being. You make all the arrangements to move, and prepare a CMS-Form 855S informing the National Supplier Clearinghouse (NSC) that you are relocating in 10 days. No one helps you fill ...
Health Law ArticlesOIG Proposes New Anti-Kickback Law Safe Harbors HIPAA Risk Assessments are Essential to Avoid Liability: Part II: Risk Analysis Medicare Termination / Medicare Revocation Cases: Tips for Avoiding & Steps for Appealing. CMS Offers Labor Day “Sale” on Audit Appeals Oncology Fraud: Michigan Oncologist Indicted for Prescribing Medically Unnecessary Chemotherapy and Other Treatment Regimens Read More Posts From This Category
Dental Law ArticlesDental Fraud Settlement — $5.05 Million to be Paid by Oklahoma Dental Practice in Medicaid Case. Medicaid Dental Fraud: Is the State of Texas Partly to Blame? Investigations of Medicaid Dental Fraud in Texas Medicaid Dental Fraud: New Hampshire Dentist Indicted on Nearly 200 Counts of Medicaid Fraud. Medicaid Dental Fraud: Dentist Alleged to Have “Systematically Bilked” the State in Dental Fraud Scheme. Read More Posts From This Category
Municipal Law ArticlesCMS Announces RAC Audit “Pause” and Additional RAC Program Reforms
The Centers for Medicare & Medicaid Services (CMS) recently announced that... [Read more of this review]Peddling and Soliciting, Municipal Regulations These Issues Can be Complex. Is Your City Clear on these Points?
(January 8, 2013): As a general rule cities can regulate hawking, canvassing,... [Read more of this review]City Contracts and Arbitration
It is recommended that cities do not agree to arbitration, either voluntarily or... [Read more of this review]Read More Posts From This Category
Business & Transaction ArticlesOIG Proposes New Anti-Kickback Law Safe Harbors
(November 10, 2014): The U.S. Department of Health and Human Services Office of Inspector... [Read more of this review]The Dangers of Keeping Medical Records in the “Cloud”
(July 3, 2014): The growing trend of storing all kinds of data in the cloud comes... [Read more of this review]Liles Parker Attorney has Article Titled “Individual Liability in Medicare Overpayment Cases” Published in Law Journal.
Will the government seek to “pierce the corporate veil”? (October 16,... [Read more of this review]Read More Posts From This Category