"Nationwide Healthcare Lawyers"
(September 17, 2015): Despite the fact that Medicare and Medicaid requires that participating providers implement a compliance plan, most small providers have yet to complete the necessary steps to accomplish this requirement. “My office manager went to a continuing education program, and she’s come back telling me we need a compliance program. I don’t know about […]
How to Implement a Compliance Plan in Your Practice Read More »
(August 15, 2015): The Centers for Medicare and Medicaid Services (CMS) has awarded the contract for Zone Program Integrity Contractor (ZPIC) services for Zone 6 to SafeGuard Services, LLC. Zone 6 encompasses Maryland, Delaware, Washington, D.C., Pennsylvania, New Jersey, New York, Connecticut, Massachusetts, Rhode Island, Vermont, New Hampshire, and Maine. SafeGuard is the current program
CMS Awards Zone 6 ZPIC Contract to SafeGuard Services Read More »
(June 1, 2015): As set out in the 2015 mid-year OIG Work Plan, the agency has once again announced its intentions to report on numerous types of potential fraud, waste, and abuse in HHS programs, as well as on the economy, efficiency, and effectiveness of the programs. The OIG plans to produce 193 reports in
The 2015 Mid-Year OIG Work Plan Has Been Released Read More »
(March 6, 2015): As we have seen in recent years, Medicaid audits resulting in dental claims False Claims Act liability are increasing around the country. Earlier this week, the U.S. Attorney’s Office, the U.S. Department of Health and Human Services. Office of Inspector General (HHS-OIG), and the Maine Attorney General’s Office announced the settlement of
Dental Claims False Claims Act Liability Read More »
(November 10, 2014): Has your dental practice been the subject of a dental fraud investigation? Medicaid dental 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
Dental Fraud Investigation Results in $5.05 Million Recovery Read More »
(September 15, 2023): Medicaid funding for personal care services allows those that need help for activities of daily living to remain in their homes and receive care from qualified individuals rather than have to live in institutional settings.[1] This is also a benefit to Medicaid, as it reduces the demand and costs for institutional and
(April 11, 2012): At a conference last week in Baltimore, Angela Brice-Smith, Acting Director of the Centers for Medicare & Medicaid Services (CMS) Medicaid Integrity Group, stated that 26 states have awarded contracts under the Medicaid RAC program, and a quarter of those states’ Medicaid RACs are now reviewing claims. Ms. Brice-Smith added that CMS
Medicaid RAC Program Up and Running – 26 States Award RAC Contracts Read More »
(May 24, 2011): On May 6, CMS proposed to amend its rules governing the adequacy of provider Medicaid payment rates. This proposed rule, may be the most important regulatory action to protect providers and beneficiaries from draconian rate reductions since the repeal of the Federal standard known as the Boren amendment, in 1997. Currently, Federal
Proposed Medicaid Payment Rates are a Potential Game Changer Read More »
(September 14, 2010): As one of the most controversial provisions in the recently enacted health care reform legislation, Congress created the IPAB – a board that is independent from Congress and the United States Department of Health and Human Services (“HHS”) as a mechanism to control Medicare – and potentially all – health care expenditures.
(July 17, 2010): Yesterday, the Department of Justice (DOJ) announced charges against 94 physicians, medical assistants, and health care company owners and executives in connection with alleged false Medicare claims amounting to more than $251 million. 24 defendants from Miami account for approximately $103 million of that amount. Four defendants were charged in Houston for
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