Annual Health Care Fraud Takedown Is Biggest Ever
Day PitneyOn June 28, the U.S. Department of Justice (DOJ) and Department of Health and Human Services Office of Inspector General (OIG) announced their annual nationwide…
CMS Plans $25 Billion Quality Initiative
The Centers for Medicare & Medicaid Services (CMS) recently announced a proposed contract action for a program entitled “Network of Quality Improvement and Innovation Contractors…
Survey: Many ACOs Will Leave Program if Required to Assume Risk
According to a recent survey by the National Association of Accountable Care Organizations (NAACOS), most of the ACOs that joined the Medicare Shared Savings Program…
Virtua Medical Group to Pay $418,000 Data Breach Settlement
Virtua Medical Group, a health network with more than 50 medical and surgical practices in southern New Jersey, has agreed to pay a $417,816 fine…
CenterLight Healthcare Reaches $10M Medicaid Fraud Settlement
CenterLight Healthcare, a managed long-term care organization that provides and coordinates healthcare services in the New York City area, has agreed to a $10.3 million…
CMS Revises Next Generation ACO Implementation Publication
On January 23, the Centers for Medicare & Medicaid Services (CMS) published on its Medicare Learning Network a revised “MLN Matters Special Edition Article” covering…
CMS Publishes Long-Awaited Guidance on Maintenance Coverage Standard Settlement
Susan HuntingtonOn August 24, the Centers for Medicare & Medicaid Services (CMS) published the long-awaited guidance required by the January 2013 Jimmo v. Sebelius Settlement Agreement, which…
Ban on Home Health and Non-Emergency Ambulance Extended Again
Included as part of its final rule on the Conditions of Participation for Home Health Agencies, the Centers for Medicare & Medicaid Services (CMS) added…
OIG to Review EHR Incentive Payments to Hospitals
A July 18 article in Bloomberg BNA’s Health Care Daily Report and other publications, “Health-Care Watchdog to Review Medicaid Opioid Claims,” discussed plans by the…
DOJ Takedown Is Biggest Healthcare Fraud Enforcement Action In History
Erin HealyOn July 13, the U.S. Department of Justice (DOJ) announced a nationwide takedown of unprecedented size, involving more than 1,000 law enforcement personnel including 350 Office of…