Last month, the Department of Health and Human Services (HHS) entered into a resolution agreement with Idaho State University (ISU) to settle HIPAA violations related to ISU’s electronic health records system. Under the agreement, ISU agreed to pay … [Continue reading]
OIG Updates its Special Advisory Bulletin on the Effect of Exclusion from Participation in Federal Health Care Programs
June 3, 2013 By
On May 8, 2013, the OIG issued an updated Special Advisory Bulletin on the Effect of Exclusion from Participation in Federal Health Care Programs (the “Updated Special Advisory Bulletin”). The Updated Special Advisory Bulletin replaces and … [Continue reading]
A Window into Hospital Charges – Medicare Releases Data on Charges and Reimbursements
May 9, 2013 By
On Wednesday, Medicare released on extensive spreadsheet documenting the average hospital charges and associated Medicare payments for 100 most common Medicare inpatient services. The release of this data is unprecedented and provides consumers a … [Continue reading]
Stark Law Really Does Have Teeth
May 9, 2013 By
Tuomey Jury Finds Monetary Value of $39 Million for 21,370 Claims Submitted in Violation of False Claims Act On May 8, 2013, the jury in the False Claims Act lawsuit against Tuomey Healthcare Systems, Inc. returned its verdict. Based on its finding … [Continue reading]
Whistleblowers Expected to Receive $2.8 Million in Settlement of Stark Based False Claims Act Lawsuit
May 7, 2013 By
The Department of Justice recently announced a settlement with Adventist Health System/West under which the Department of Justice and the state of California will collect $14.1 million in settlement of False Claims Act allegations. The lawsuit was … [Continue reading]
Tax-Exempt Hospitals: IRS Issues Proposed Regs Under IRC 501(r) Regarding Community Health Needs Assessments
May 3, 2013 By
In response to Congressional concerns that there was little to distinguish a for-profit hospital from a tax-exempt nonprofit hospital, Congress enacted IRC 501(r) which mandates that tax-exempt nonprofit hospitals: 1. Conduct community … [Continue reading]
False Claims Act Recoveries Top $14.2 Billion
May 2, 2013 By
On May 1, 2013, the Department of Justice announced a settlement with two Montana hospitals that added $3.95 million to its recoveries under the False Claims Act. According to the announcement, with this additional recovery, the Department of … [Continue reading]
CMS PROPOSES TO INSPIRE MORE WHISTLE BLOWING
April 25, 2013 By
In a recently published proposed rule, CMS and HHS propose to substantially increase financial rewards available to individuals who report information regarding individuals or entities engaging in acts or conduct that are subject to Medicare … [Continue reading]
Sequester Payment Reductions to Medicare EHR Incentive Payments
April 19, 2013 By
CMS has confirmed that the mandatory reductions in federal spending aka the sequester will affect the Medicare EHR Incentive Program payments made in 2013. Accordingly, all Medicare EHR Incentive Program payments made to hospitals and eligible … [Continue reading]
OIG Issues Updated Self-Disclosure Protocol
April 17, 2013 By
The OIG recently issued an update to its self-disclosure protocols to supply providers with additional guidance for self-disclosure. In touting the benefits of self-disclosure, the OIG update notes that it now rarely requires integrity agreements in … [Continue reading]
