Legal and practical healthcare information.
The government is continuing to take a close look at laboratory testing in the wake of the COVID-19 pandemic. On February 21, 2024, a federal grand jury in New Jersey issued a superseding indictment against a New York physician. The indictment claims the physician committed healthcare fraud and conspired to defraud the United States by …
Continue reading “NY Doctor Indicted for Medicare Fraud Related to Genetic Testing and Equipment”
On November 1, 2022, the Centers for Medicare & Medicaid (CMS) under the United States Department of Health and Human Services (HHS) finalized changes that are projected to significantly expand access to behavioral health care services, among other things. CMS released a Behavioral Health Strategy in 2022, which included improving access to and quality of …
For the majority of the 2010s, the Medicare appeals process had become extremely backlogged. The Office of Medicare Hearings and Appeals (“OMHA”) is in charge of administering the Administrative Law Judge (“ALJ”) hearing program for appeals arising from Medicare claims and disputes. Pursuant to 42 U.S.C. § 1395ff(d)(1)(A), an ALJ is statutorily required to provide …
Continue reading “Update to the ALJ Backlog for Medicare Appeals”
On November 20, 2020, the Centers for Medicare & Medicaid Services (“CMS”) and the Office of the Inspector General (“OIG”) finalized the rules modifying the safe harbors under the Anti-Kickback Statute and exceptions under the Stark Law. These new rules take effect as of January 19, 2021. Due to their complexity, this article will focus …
The Trump administration proposed a budget increase of 19 million to aid in the fight against health care fraud. This showcases the continued (and heightened) importance of anti-fraud programs, especially compared to the suggested $18 billion in cuts to other health-care related programs. If approved by Congress, the budget increase will result in an increase …
Continue reading “The Trump Administration Proposes a Budget Increase to Fight Healthcare Fraud”