Medicare and Medicaid


Rivkin Attorneys to Speak at “The Business of Medicine” Seminar
January 14, 2019 | Rivkin Rounds Staff | Employer/Employee | Fraud and Abuse | HIPAA | Hospitals | Medicare and Medicaid
Rivkin Radler’s Jeffrey Rust and Eric Fader will be among the presenters at “The Business of Medicine,” a seminar to be held on Saturday, January 26, 2019, at the Convene conference center, 101 Park Avenue (at 41st Street), New York, New York. Neuro Alert Services LLC, a multistate provider of intraoperative neurophysiologic monitoring services, designed …
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Starting the New Year with Hospital Price Transparency
January 8, 2019 | Cassandra Rivais | Affordable Care Act | Hospitals | Legislation and Public Policy | Medicare and Medicaid
As of January 1, hospitals are now required to post charges for their standard items and procedures online in an effort to increase price transparency. Section 2718(e) of the Public Health Service Act, part of the Affordable Care Act, requires each hospital in the U.S. “for each year [to] establish (and update) and make public …
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The False Claims Act: A Powerful Tool Against Federal Health Care Program Fraud
January 7, 2019 | Rivkin Rounds Staff | False Claims Act | Fraud and Abuse | Litigation | Medical Devices | Medicare and Medicaid | Pharmaceuticals
Evan Krinick authored an article, “The False Claims Act: A Powerful Tool Against Federal Health Care Program Fraud,” that was published in the New York Law Journal.  The article discusses recent actions taken by U.S. Attorneys in New York against health care providers under the FCA. …
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Here’s Why Your Tax Dollars Are Overpaying for Medicaid
January 3, 2019 | Rivkin Rounds Staff | Legislation and Public Policy | Medicare and Medicaid
A January 2 article in Bloomberg Law’s Health Law & Business, “Here’s Why Your Tax Dollars Are Overpaying for Medicaid,” discussed the Medicaid program’s difficulty in recovering inappropriate payments made by states to doctors. A December 11 report by the U.S. Department of Health and Human Services’ Office of Inspector General (OIG) said the lack …
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Midterm Election Results: 6 Ways Healthcare Could Change in 2019
December 27, 2018 | Rivkin Rounds Staff | Affordable Care Act | Legislation and Public Policy | Medicare and Medicaid | Pharmaceuticals
A December 6 article in Managed Healthcare Executive, “Midterm Election Results: 6 Ways Healthcare Could Change in 2019,” discussed how Congress may attempt to address various healthcare issues next year. Rivkin Radler’s Eric Fader was quoted in the article. Eric pointed out that the recently enacted Know the Lowest Price Act and Patient Right to Know Drug Prices Act will …
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Hospitals Still Faxing and Mailing Patient Records
December 21, 2018 | Eric D. Fader | Electronic Health Records | Hospitals | Medicare and Medicaid
A recent study by the Office of the National Coordinator for Health Information Technology revealed that most hospitals were still transmitting at least some patient medical records by mail or fax in 2017. The data showed that industry-wide electronic interoperability remains a distant goal. According to the study, 66% of the hospitals surveyed sometimes sent …
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OMIG Issues Changes to December 2018 Certification
December 10, 2018 | Ashley S. Osadon | Fraud and Abuse | Hospitals | Medicare and Medicaid
The New York State Office of the Medicaid Inspector General (OMIG) has issued updates to its certification process for applicable Medicaid and Managed Medicaid providers, which may have a significant impact on providers who are required to certify by December 31, 2018. OMIG has expanded its certification to adopt five separate categories listed on the …
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CMS Finalizes Reimbursement for New Virtual Services
November 21, 2018 | Eric D. Fader | Legislation and Public Policy | Medicare and Medicaid | Telehealth
The final 2019 Medicare Physician Fee Schedule released on November 1, 2018 by the Centers for Medicare & Medicaid Services (CMS) includes a section entitled “Modernizing Medicare Physician Payment by Recognizing Communication Technology-Based Services.” Effective January 1, 2019, physicians may be reimbursed for certain virtual interactions with patients using several new billing codes. One new …
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Deadline Approaches to Certify Compliance Programs
November 20, 2018 | Ashley S. Osadon | Fraud and Abuse | Hospitals | Medicare and Medicaid
The December 31 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 payors …
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Dental Clinics are First on OIG’s “High Risk” List
November 16, 2018 | Margarita Christoforou | Fraud and Abuse | Litigation | Medicare and Medicaid
Two dental care companies are the first entities to be placed on the new High Risk – Heightened Scrutiny list created by the U.S. Department of Health and Human Services’ Office of Inspector General (OIG) for providers that pose a significant risk to federal healthcare programs and beneficiaries.  Each of the companies settled with the …
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