Medicare and Medicaid


Final Stark Law and Anti-Kickback Rules Released
November 24, 2020 | Eric D. Fader | Fraud and Abuse | Legislation and Public Policy | Medicare and Medicaid
On November 20, the Centers for Medicare & Medicaid Services (CMS) and the Department of Health and Human Services’ Office of Inspector General (OIG) announced the issuance of long-awaited final rules to modernize the Stark Law and federal Anti-Kickback Statute (AKS). Proposed changes, intended to promote value-based arrangements for providers and coordinated care for patients, …
Read More
OIG Issues Special Fraud Alert on Speaker Programs
November 20, 2020 | Eric D. Fader | Fraud and Abuse | Legislation and Public Policy | Litigation | Medical Devices and Wearables | Medicare and Medicaid | Pharmaceuticals
The U.S. Department of Health and Human Services’ Office of Inspector General (OIG) issued a Special Fraud Alert on November 16, warning that speaker programs organized by pharmaceutical and medical device companies pose inherent fraud and abuse risks. OIG is “skeptical about the educational value of such programs” and cautioned that remuneration to referring practitioners …
Read More
Medtronic Settles Kickback and Open Payments Violations for $9.2M
November 13, 2020 | Eric D. Fader | Affordable Care Act | False Claims Act | Fraud and Abuse | Litigation | Medical Devices and Wearables | Medicare and Medicaid
The U.S. Department of Justice (DOJ) announced on October 29 that Medtronic USA Inc. agreed to pay $8.1 million to settle allegations that it violated the False Claims Act (FCA) and federal Anti-Kickback Statute by paying kickbacks to a South Dakota neurosurgeon to use Medtronic’s medical devices. Medtronic will pay an additional $1.11 million for …
Read More
Significant Changes to Simplify the OMIG Annual Compliance Certification Process
November 10, 2020 | Ashley (Osadon) Algazi | Legislation and Public Policy | Medicare and Medicaid
The New York State Office of the Medicaid Inspector General (OMIG) instituted changes to its annual compliance certification process, effective immediately. These changes apply to those Medicaid, Managed Medicaid, and Service Bureau providers subject to the mandatory compliance program requirements in Section 363-d of the New York State Social Services Law (SSL) and the Deficit …
Read More
New Relief Funds; Eased Lending Terms for Accelerated Payments
October 30, 2020 | Rivkin Rounds Staff | Behavioral Health | Hospitals | Legislation and Public Policy | Medicare and Medicaid | Nursing Homes
An October 22 article in Part B News, “Welcome third round HHS relief funds, eased lending terms for accelerated payments,” discussed the Centers for Medicare & Medicaid Services’ Accelerated and Advance Payment Program (recently discussed here) and the Department of Health and Human Services’ CARES Act Provider Relief Program (recently discussed here). Rivkin Radler’s Eric …
Read More
$50 Million Stark Settlement Shows Risk of Violation, Whistleblowers
October 21, 2020 | Rivkin Rounds Staff | False Claims Act | Fraud and Abuse | Hospitals | Litigation | Medicare and Medicaid
An article in the November issue of Healthcare Risk Management, “$50 Million Stark Settlement Shows Risk of Violation, Whistleblowers,” discussed Wheeling Hospital’s $50 million settlement with the U.S. Department of Justice (DOJ) that resolved a whistleblower complaint filed in 2017 by a former executive of the hospital. Rivkin Radler’s Jeff Kaiser was quoted in the …
Read More
Health Providers Get More Time to Repay Medicare Loans
October 15, 2020 | Rivkin Rounds Staff | Hospitals | Legislation and Public Policy | Medicare and Medicaid | Nursing Homes
On October 8, the Centers for Medicare & Medicaid Services (CMS) released new details on repayment terms for the Medicare Accelerated and Advance Payments Program, a loan program that sent aid to Medicare Part A providers and certain Part B suppliers to help the ease the financial burdens caused by the COVID-19 pandemic. CMS also …
Read More
CA Lab Pays $3 Million to Settle FCA Case
October 12, 2020 | Rivkin Rounds Staff | False Claims Act | Fraud and Abuse | Litigation | Medicare and Medicaid
On October 2, the U.S. Department of Justice (DOJ) announced that Phamatech, Inc. and its CEO have agreed to pay $3,043,484 to settle alleged False Claims Act (FCA) allegations. San Diego-based Phamatech, a medical technology company that manufactures diagnostic devices and provides laboratory testing, allegedly submitted false claims to Medicare for drug-testing services. In addition …
Read More
A look at 4 value-based care programs
October 5, 2020 | Rivkin Rounds Staff | ACOs | Hospitals | Legislation and Public Policy | Medicare and Medicaid | Private Insurers
A September 30 article in Managed Care Executive, “Are we there yet? A look at 4 value-based care programs,” offered a snapshot of four value-based care programs being undertaken by the Centers for Medicare & Medicaid Services (CMS) and Blue Cross Blue Shield of Massachusetts. Rivkin Radler’s Chris Kutner was quoted in the article. Chris gave …
Read More
HHS Announces $20 Billion in Phase 3 Provider Relief Funding
October 2, 2020 | Ashley (Osadon) Algazi | Behavioral Health | Legislation and Public Policy | Medicare and Medicaid
On October 1, the U.S. Department of Health and Human Services announced $20 billion in additional funding as part of its Phase 3 Provider Relief Fund. This large push from the government is meant to (a) ensure that all eligible providers who received prior provider relief distributions have a balanced equitable payment equal to 2% …
Read More

Authors
show more

Get legal updates and news delivered to your inbox