OIG Report: CMS Made Nearly $100 Million in Incorrect EHR Incentive Payments
December 26, 2019 | Eric D. Fader | Hospitals | Medicare and Medicaid

A December 16 report by the U.S. Department of Health and Human Services’ Office of Inspector General (OIG) estimated that the Centers for Medicare & Medicaid Services (CMS) made tens of millions of dollars of inflated Medicare electronic health record (EHR) incentive payments over a four-year period. OIG examined a sample of 99 payments made

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Sutter Health to Pay $575 Million in Antitrust Settlement
December 23, 2019 | Eric D. Fader | Antitrust | Hospitals | Litigation | Private Insurers

Sutter Health, a northern California health system, will pay $575 million to settle allegations that it violated federal antitrust laws. The settlement comes on the heels of Sutter’s recent $45 million settlement of alleged Stark Law violations, as discussed here.

Under the preliminary settlement, which is pending court approval, Sutter will be required to reform

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HIPAA Access Violation Costs Provider $85,000
December 19, 2019 | Eric D. Fader | Electronic Health Records | HIPAA | Hospitals | Litigation

A Florida primary care and pain management practice that calls itself Korunda Medical Institute has paid the federal government $85,000 to settle a violation of HIPAA’s right of access provisions. The U.S. Department of Health and Human Services (HHS) announced the settlement on December 12.

A Korunda patient filed a complaint with HHS’s Office for

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Genetic Testing Fraudster to Plead Guilty
December 11, 2019 | Eric D. Fader | Fraud and Abuse | Litigation | Medicare and Medicaid | Telehealth

The U.S. Department of Justice’s campaign against genetic testing scams continues and the latest accused lab owner is set to plead guilty. Ravitej Reddy, the owner of Personalized Genetics in Pittsburgh and Med Health Services Management in nearby Monroeville, was charged in November with paying kickbacks in a conspiracy to induce referrals for $127 million

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Sentara in $2.175 Million Settlement for Improper HIPAA Breach Reporting
December 10, 2019 | Eric D. Fader | HIPAA | Home Health | Hospitals | Litigation

The U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) announced on November 27 that Sentara Healthcare agreed to pay $2.175 million to settle allegations that it failed to properly report a breach of protected health information. Sentara operates 12 acute care hospitals and provides other types of care at more than

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NY Deadline Approaching to Certify Compliance Programs
December 9, 2019 | Rivkin Rounds Staff | Fraud and Abuse | Home Health | Hospitals | Legislation and Public Policy | Medicare and Medicaid

The annual December 31st deadline for certain Medicaid providers and third-party billers to certify as to the effectiveness of their compliance program is fast approaching.

New York State Medicaid providers and third-party billing companies who claim, bill, order or receive at least $500,000 in any consecutive 12-month period from the Medicaid Program or Managed Medicaid

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Fader Gives Perspective on HIPAA Enforcement for Healthcare Risk Management
December 4, 2019 | Rivkin Rounds Staff | Cybersecurity | Electronic Health Records | HIPAA | Hospitals | Legislation and Public Policy | Litigation

Eric Fader contributed to Healthcare Risk Management’s HIPAA Regulatory Alert, which appeared in the publication’s December 2019 issue. The Alert outlines the best practices that will help avoid common HIPAA violations. Eric discusses the events that might trigger a regulatory action and the kinds of violations that may affect the severity of the penalties and fines.

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