Medicare and Medicaid


EHR Exposé Shakes Up Industry
March 19, 2019 | Eric D. Fader | Electronic Health Records | False Claims Act | Fraud and Abuse | Hospitals | Legislation and Public Policy | Litigation | Medicare and Medicaid
A three-month joint investigation of electronic health records (EHR) systems has culminated in a release of a March 18 article in Kaiser Health News (KHN) and Fortune Magazine, “Death By 1,000 Clicks: Where Electronic Health Records Went Wrong.” The lengthy, meticulously sourced article calls EHR systems “an unholy mess.” KHN and Fortune have made the …
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Managing “Social Determinants of Health” a Key Issue for Health Systems
March 14, 2019 | Rivkin Rounds Staff | Home Health | Hospitals | Legislation and Public Policy | Medicare and Medicaid
The World Health Organization (WHO) defines social determinants of health (SDOH) as the conditions in which people are born, grow, live, work and age that are primarily responsible for differences in health status. Rivkin Radler’s Robert Iseman recently penned a Thought Leaders’ Corner column for Population Health News in which he made suggestions regarding how healthcare organizations …
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CMS to Propose Significant Changes to Stark Law
March 7, 2019 | Cassandra Rivais | Fraud and Abuse | Legislation and Public Policy | Medicare and Medicaid
At the Federation of American Hospitals’ 2019 Public Policy Conference on March 4, Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma announced the agency’s plan to make dramatic changes to the federal physician self-referral prohibition, commonly known as the Stark Law. The changes are designed to support a value-based model of care in …
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CMS Proposed Rule Focuses on Patient Access to Health Info
February 21, 2019 | Eric D. Fader | Electronic Health Records | HIPAA | Hospitals | Legislation and Public Policy | Medicare and Medicaid
Yesterday’s Rivkin Rounds post discussed the Proposed Rule on information blocking recently released by the Office of the National Coordinator for Health Information Technology (ONC). The Centers for Medicare & Medicaid Services (CMS) simultaneously released its own 251-page Proposed Rule, addressing some of the same concerns but focused on interoperability and patients’ access to their …
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EHR Vendor to Pay $57 Million to Settle FCA Case
February 11, 2019 | Geoffrey R. Kaiser | Electronic Health Records | False Claims Act | Fraud and Abuse | Litigation | Medicare and Medicaid
On February 6, the U.S. Department of Justice announced that Greenway Health LLC, a Florida-based developer of electronic health records (EHR) software, will pay $57.25 million as part of a False Claims Act settlement. The United States had alleged that Greenway misrepresented the capabilities of its software product, called “Prime Suite,” causing healthcare providers to submit …
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New Medicare App to Explain Coverage
February 6, 2019 | Cassandra Rivais | Hospitals | Medical Devices and Wearables | Medicare and Medicaid | Pharmaceuticals | Private Insurers
On January 28, the Centers for Medicare & Medicaid Services (CMS) announced the launch of a new mobile app called “What’s Covered” to help consumers understand which items and services are covered by Medicare. The app is part of the eMedicare Initiative, launched in October 2018 to modernize the delivery of information about the program. …
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Pathology Lab Company to Pay $63.5 Million to Settle FCA Case
February 5, 2019 | Christopher J. Kutner | Electronic Health Records | False Claims Act | Fraud and Abuse | Litigation | Medicare and Medicaid
Inform Diagnostics, a Texas-based pathology laboratory company, will pay the federal government $63.5 million to resolve allegations that the company violated the False Claims Act (FCA). The U.S. Department of Justice announced the settlement on January 30. Inform Diagnostics was alleged to have engaged in improper financial relationships with physicians, including providing them with subsidies …
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Walgreens Pays $269.2 Million to Settle Fraud Allegations
January 24, 2019 | Geoffrey R. Kaiser | False Claims Act | Fraud and Abuse | Litigation | Medicare and Medicaid | Pharmaceuticals
Walgreens Boots Alliance, Inc., the operator of the Walgreens pharmacy chain, has agreed to pay $269.2 million in two settlements with the U.S. Department of Justice to resolve fraud allegations. The two cases arose from lawsuits filed by whistleblowers under the False Claims Act and were prosecuted federally by the U.S. Attorney’s Office for the Southern …
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Orthodontic Practice Pays $9 Million Settlement
January 23, 2019 | Eric D. Fader | Fraud and Abuse | Litigation | Medicare and Medicaid
On January 15, New York Attorney General Letitia James announced that Diamond Braces, an orthodontic practice with 10 offices in the State of New York, has settled charges that it allowed uncertified employees to perform orthodontic procedures and then improperly billed the Medicaid program for the procedures. The settlement included $4.5 million in restitution for …
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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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