Compliance Investigations & White Collar


Shapiro Publishes Article in Nutrition Industry Executive
December 12, 2018 | Steven Shapiro | Compliance Investigations & White Collar | Health Services
Steven Shapiro published an article in Nutrition Industry Executive, “What is Slack-fill & Why You Need to Know.” Click here to read the article. …
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UPDATE: OMIG Issues Changes to December 2018 Certification
December 7, 2018 | Ashley S. Osadon | Health Services | Compliance Investigations & White Collar
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 updated Social Services Law Certification Form: (i) Annual Certification, (ii) …
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Deadline Approaches to Certify Compliance Programs
November 20, 2018 | Ashley S. Osadon | Health Services | Compliance Investigations & White Collar
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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Federal Government Agrees to Global $260M Settlement with Florida Hospital Chain
October 10, 2018 | Geoffrey R. Kaiser | Health Services | Compliance Investigations & White Collar
The United States recently agreed to a $260 million settlement of criminal charges and related civil claims under the False Claims Act arising from a scheme to defraud conducted by Naples, Florida-based hospital chain Health Management Associates, LLC (HMA). The Department of Justice (DOJ) announced the settlement on September 25. The settlement is evidence of …
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OMIG Audits: Failure to Provide Comments Can Prove Costly
September 19, 2018 | James P. Lagios | Margarita Christoforou | Health Services | Compliance Investigations & White Collar
Healthcare providers must not only be knowledgeable in their respective specialties, they must also understand and comply with the multitude of regulations that not only directly affect their practice of medicine, but also their payment for the services rendered. After all, “those who deal with the government are expected to know the law, and cannot …
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OIG: Telehealth Equipment Donation Presents Low Risk of Fraud and Abuse
| Geoffrey R. Kaiser | Ada Kozicz | Health Services | Compliance Investigations & White Collar
In a recent advisory opinion, the U.S. Department of Health and Human Services, Office of Inspector General (OIG) concluded that a proposed donation of telehealth equipment to a referral source presented a low risk of fraud and abuse under the federal Anti-Kickback Statute. The conclusion was premised on several factors, one of which included OIG’s …
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Iseman Authors Article in USLAW Magazine
September 13, 2018 | Robert H. Iseman | Compliance Investigations & White Collar
Robert Iseman authored a USLAW article, “A Long Way From ‘Guns That Don’t Shoot’ – 18 Proactive, Self-Defense Tactics Against the Ever-Expanding Application of the False Claims Act,” in the Fall/Winter issue of USLAW Magazine. Click here to read the Article. …
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Telehealth in NY: Compliance Requirements Create Reimbursement Challenges
June 13, 2018 | Jeffrey P. Rust | Health Services | Compliance Investigations & White Collar
The utilization of telehealth services has increased significantly over the last decade. The advent of new technologies and the development of far reaching and readily available wireless and cellular networks have made instantaneous communication with medical professionals possible. Considering the demand for healthcare in remote locations, the growth of the geriatric population, and the need …
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‘Made in the USA’ Claims: Handle With Care
May 15, 2018 | Marc S. Ullman | Compliance Investigations & White Collar
Marc Ullman published an article in Natural Products Insider entitled, “‘Made in the USA’ Claims: Handle With Care.” The article focuses on how the Federal Trade Commission has increased its enforcement of its “Made in the USA” standards, which states “all or virtually all” of a product must be made/produced in the United States. Click …
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OIG Report Highlights Telehealth Reimbursement Challenges
May 10, 2018 | Geoffrey R. Kaiser | Compliance Investigations & White Collar | Health Services
The utilization of telehealth has flourished over the last decade as innovative technologies and new Medicare regulations have fueled telehealth’s growth. Between 2001 and 2015, Medicare telehealth spending increased by nearly 300% as a result of this boom. However, as the utilization of telehealth services has surged, so have the compliance issues associated with these …
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