Administration’s FY 2016 Budget Proposal Includes Changes to Recovery Audit Procedures
(2/27/15) On February 2, 2015, President Obama released his fiscal year 2016 budget proposal. This latest proposal affects a significant number of Federal health care programs and includes over $1 trillion allocated to the U.S. Department of Health and Human Services (“HHS”). More than 85 percent of HHS’s budget is devoted to programs that fall under the purview of the Centers for Medicare & Medicaid Services (“CMS”). I. Administration Goals The administration’s primary health care focus is expanding access to care and providing higher quality of care. It attempts to accomplish this goal through a series of budget increases coupled with ...
RECENT DEVELOPMENTS IN INDIVIDUAL LIABILITY FOR MEDICARE OVERPAYMENT CLAIMS
New Rules and Risks to Individual Owners for Claims against their Companies by CMS and Federal Contractors By David P. Parker, Washington, DC Summary: Medicare recently finalized regulations allowing enrollment as a Medicare provider to be denied if any owner or control person of the enrolling provider is affiliated with another provider which owes money to Medicare. These regulations are based on sections of the 2010 Affordable Care Act (the “ACA”). They provide CMS an indirect means to penalize individual owners for unpaid debts owed to Medicare by their provider companies, but are more narrowly written than the ACA requires, and are ...
Texas Physicians Must Establish “Defined Physician-Patient Relationship” for Online Prescription
(February 5th, 2015) The Texas Medical Board recently set forth a proposed rule that would dictate what physicians must do in order to prescribe certain medications or face sanctions. Under the proposed rule, Texas physicians must establish a “defined physician-patient” relationship in order to prescribe any dangerous drug or controlled substance. This relationship must include, at a minimum, establishing a diagnosis through a physical examination. Importantly, this examination must be performed through a valid face-to-face visit or in-person evaluation. The face-to-face visit or in-person evaluation does not necessarily have to occur “in person”; physicians may use sufficient medical and technological equipment – ...
Massive Breach at Health Insurer Anthem
Anthem, Inc., the nation’s second-largest health insurance company, has suffered a data breach that may have exposed the account information for as many as 80 million members. "Anthem was the target of a very sophisticated external cyber attack," Anthem president and CEO Joseph Swedish said in a statement posted on a website Anthem created for information about the incident. The hackers gained access to the company’s IT system and account information that included patient names, birthdays, medical IDs / Social Security numbers, street addresses, e-mail addresses and employment information, including income data. The breach even included access to the personal information for ...
Health Law ArticlesAdministration’s FY 2016 Budget Proposal Includes Changes to Recovery Audit Procedures RECENT DEVELOPMENTS IN INDIVIDUAL LIABILITY FOR MEDICARE OVERPAYMENT CLAIMS Texas Physicians Must Establish “Defined Physician-Patient Relationship” for Online Prescription Massive Breach at Health Insurer Anthem New Medicare Incentive Programs Read More Posts From This Category
Dental Law ArticlesMedicaid Dental Audit: Exclusion Screening Issues Dental 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. Read More Posts From This Category
False Claims ActDental Fraud Settlement — $5.05 Million to be Paid by Oklahoma Dental Practice in Medicaid Case.
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Business & Transaction ArticlesCloud Storage Providers & BAAs – Where is Your Data?
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