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

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

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

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

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.

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

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.

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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

A recent report issued by the U.S. Department of Health and Human Services, Office of Inspector General (OIG), estimates that 61% of claims submitted to Medicare for outpatient physical therapy (PT) services failed to comply with Medicare requirements. The OIG report serves as a reminder to PT providers about the importance of accurate billing and

Geoffrey R. Kaiser’s article, “Government Dismissal under the False Claims Act: Policy Change or Much Ado About Nothing?” was published in Westlaw Journal White Collar Crime in the March 2018 issue.

Click here to read the article.