RECENT HEALTH LAW NEWS


Avoiding the Pitfalls in Recent Government Enforcement
December 02, 2022 | Rivkin Rounds Staff | Fraud and Abuse | Legislation and Public Policy | Litigation | Medicare and Medicaid | Private Insurers
In the next installment of Rivkin Radler’s Healthcare Compliance Lunch & Learn series, Rivkin Radler’s Ben Malerba and Ben Wisher will discuss Avoiding the Pitfalls in Recent Government Enforcement. The program will cover recent audits, investigations and actions of government agencies including DOJ, MFCU, OMIG, the NY AG, and others. …
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Connecticut Doctor Pleads Guilty to Fraud and Kickbacks
November 30, 2022 | Eric Fader | Fraud and Abuse | Litigation | Medicare and Medicaid
The U.S. Attorney’s Office for the District of Connecticut announced on November 3 that Ananthakumar Thillainathan, a physician with offices in Stratford and Milford, pleaded guilty to healthcare fraud and federal kickback violations. The doctor faces up to 20 years in prison and a restitution payment of almost $1.7 million.…
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Pharmacy Not Liable for Filling Prescriptions as Ordered
November 30, 2022 | Eric Fader | Litigation | Pharmaceuticals
A Suffolk County, New York court held on November 16 that White’s Apothecary in East Hampton was not negligent when it filled a physician’s opioid and benzodiazepine prescriptions as ordered. The plaintiff had claimed that the pharmacy should be liable for filling “excessive and dangerous doses” of oxycodone and Carisoprodol,…
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Former Hospital Employees and Kingpin Indicted for HIPAA Violations
November 23, 2022 | Eric Fader | HIPAA | Hospitals | Litigation
The U.S. Department of Justice announced on November 10 that five former employees of Methodist Hospital, based in Memphis, Tennessee, were indicted by a federal grand jury for allegedly selling the names and telephone numbers of hospital patients who were involved in automobile accidents. Roderick Harvey paid them for the…
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NY Pharmacy Owners Plead Guilty to Money Laundering During COVID-19
November 21, 2022 | Ada Janocinska | COVID-19 | Fraud and Abuse | Litigation | Medicare and Medicaid | Pharmaceuticals
The U.S. Department of Justice (DOJ) announced on November 16 that two pharmacy owners from Forest Hills, New York have pleaded guilty to conspiracy to commit money laundering through submission of fraudulent claims to Medicare during the COVID-19 pandemic. The co-conspirators owned over a dozen pharmacies in the New York…
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CMS Adds New Billing Code for Dental Surgeries
November 18, 2022 | Eric Fader | Dentistry | Legislation and Public Policy | Medicare and Medicaid
The American Dental Association (ADA) announced on November 15 that the Centers for Medicare & Medicaid Services (CMS) has agreed to create a new Healthcare Common Procedure Coding System (HCPCS) code G0330 for dental surgeries performed under anesthesia in hospital operating rooms. The new code resulted from an advocacy campaign…
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Artificial Intelligence Now Powers Orthodontics
November 11, 2022 | Eric Fader | Dentistry
Align Technology, the manufacturer of the Invisalign system of orthodontic braces, recently announced the release of an improved artificial intelligence-assisted smartphone app that can direct an Invisalign wearer when to advance to his or her next set of aligners. The company’s “Virtual Care AI-assisted Remote Monitoring Solution” helps patients take…
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The Triple Threat of Workers’ Compensation Fraud
November 04, 2022 | Rivkin Rounds Staff | Fraud and Abuse | Litigation | Medicare and Medicaid
Rivkin Radler’s Michael Sirignano authored an article for the November 3 issue of the New York Law Journal entitled “The Triple Threat of Workers’ Compensation Fraud.” Although the article wasn’t in time for Rivkin Rounds’ recent Fraud Week, it discussed some recent attempts by healthcare providers to game the workers’…
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New Employment Laws and Regulations Regarding Marijuana in the Workplace
October 31, 2022 | Rivkin Rounds Staff | Cannabis | Employer/Employee | Legislation and Public Policy
In the next installment of Rivkin Radler’s Healthcare Compliance Lunch & Learn series, Rivkin Radler Partners John Diviney and Tamika Hardy will discuss New Employment Laws and Regulations Regarding Marijuana in the Workplace. The program will cover the following topics: New state laws – New York Marijuana Regulation and Taxation…
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The Family Health Care Decisions Act’s Limitations
October 31, 2022 | Frank Izzo and Joseph Pidel | Hospitals | Legislation and Public Policy
On any given day, a medical practitioner will evaluate a patient, determine the appropriate care and then provide the required services upon the patient’s consent. However, what happens if a patient lacks capacity and is unable to consent to treatment and has no designated decision maker to take on that…
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Fraud Week: Pharmacy Kickbacks, Fake Medical Directorships and More
October 28, 2022 | Eric Fader | False Claims Act | Fraud and Abuse | Litigation | Medical Devices and Wearables | Medicare and Medicaid | Pharmaceuticals
Federal and state enforcement activity involving pharmacy fraud tops the list of categories in this edition of Rivkin Rounds’ Fraud Week. We’ll list just a sampling of cases. On October 19, the U.S. Department of Justice (DOJ) announced that Jerry May Keepers of Kingswood, Texas was sentenced to 36 months…
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Fraud Week: DOJ Targets DME Fraud
October 27, 2022 | Eric Fader | False Claims Act | Fraud and Abuse | Litigation | Medicare and Medicaid
Home health-related fraud and dentists behaving badly (see this week’s earlier posts) have both been notable recent trends, but the U.S. Department of Justice (DOJ) has been even busier lately cracking down on fraud involving durable medical equipment. Most recently, on October 25, DOJ announced that Daniel Canchola of Flower…
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Fraud Week: Kickbacks for Home Healthcare Referrals
October 26, 2022 | Eric Fader | False Claims Act | Fraud and Abuse | Home Health | Litigation | Medicare and Medicaid
The U.S. Department of Justice (DOJ) announced on October 18 that Oklahoma-based Carter Healthcare LLC and its affiliates, plus two executives, agreed to pay a total of over $30 million to resolve two separate qui tam cases. One lawsuit claimed that Carter paid remuneration to physicians in Oklahoma and Texas…
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Fraud Week: Medically Unnecessary Pediatric Root Canals
October 25, 2022 | Eric Fader | Dentistry | False Claims Act | Fraud and Abuse | Litigation | Medicare and Medicaid
The U.S. Attorney for the District of New Jersey and New York Attorney General Letitia James both announced on October 6 that pediatric dentist Barry L. Jacobson, his management company, and 13 affiliated pediatric dentistry practices agreed to pay $753,457 to resolve allegations of False Claims Act violations. Between 2011…
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Telehealth on Your TV?
October 21, 2022 | Eric Fader | Hospitals | Telehealth
Virtual primary care company HealthTap recently announced that it has partnered with Samsung to provide telehealth services through Samsung smart TVs. Users will be able to connect to the HealthTap platform and schedule a doctor visit using a built-in camera on the television. Consumers who pay $15 per month for…
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HHS Extends COVID-19 PHE Again
October 17, 2022 | Eric Fader | COVID-19 | Legislation and Public Policy | Medicare and Medicaid | Telehealth
On October 13, U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra formally renewed the federal COVID-19 public health emergency (PHE) for another 90 days. The PHE, which originally went into effect on January 31, 2020, provides important flexibilities for healthcare providers, including expanding the types of telehealth…
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Former NJ Doc Pleads Guilty to HIPAA Violations
October 12, 2022 | Eric Fader | HIPAA | Litigation | Pharmaceuticals
On October 7, the U.S. Attorney’s Office for the District of New Jersey announced that a former physician pleaded guilty to conspiring to wrongfully disclose patients’ protected health information to a pharmaceutical sales representative. Frank Alario, who had had numerous offices in New Jersey, Manhattan and Florida, admitted to criminal…
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DOJ Issues New Guidance on Criminal Enforcement
October 10, 2022 | Jeff Kaiser | Fraud and Abuse | Legislation and Public Policy | Litigation
On September 15, Deputy Attorney General (“DAG”) Lisa Monaco delivered remarks announcing updated guidance on how the Department of Justice will be prioritizing and prosecuting corporate crime.  Her remarks were accompanied by a formal memo, titled “Further Revisions to Corporate Criminal Enforcement Policies Following Discussions with Corporate Crime Advisory Group”…
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Overpayments and Self-Disclosures
October 06, 2022 | Rivkin Rounds Staff | False Claims Act | Fraud and Abuse | Legislation and Public Policy | Medicare and Medicaid
In the next installment of Rivkin Radler’s Healthcare Compliance Lunch & Learn series, Bob Hussar will discuss Overpayments and Self-Disclosures. Bob is a partner in Rivkin Radler’s Compliance, Investigations & White Collar and Health Services practice groups. The program will cover: • Identifying whether you have an overpayment or potential…
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Fitbit Unveils Smartwatch AFib Detection
September 30, 2022 | Joseph DiBella | Medical Devices and Wearables
In a recent blog post, Fitbit unveiled three new devices in its product line. One of the newly debuted watches, the Sense 2, includes an atrial fibrillation (AFib) detection algorithm that recently received FDA clearance. The AFib detection technology relies on a photoplethysmography (PPG) optical heart-rate sensor that reads the heart…
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Dental Orgs Urge CMS to Expand Access to ASCs
September 29, 2022 | Sean Simensky | Dentistry | Legislation and Public Policy | Medicare and Medicaid
On September 13, a coalition of leading dental organizations sent a letter to the Centers for Medicare & Medicaid Services (CMS) urging CMS to increase access to dental surgeries in ambulatory surgical centers (ASCs). The letter was signed by the American Academy of Pediatric Dentistry, American Dental Association, and American…
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Trending Topics in Health Law Journals
September 27, 2022 | Rivkin Rounds Staff | Uncategorized
The New York State Bar Association’s Health Law Journal recently published Jeff Ehrhardt’s column, a compendium of citations to recent and trending topics in health law journals. The complete issue of the Journal is available here. Sign up to receive Rivkin Rounds at www.RivkinRounds.com. Continue Reading
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Use of the False Claims Act in Health Care Fraud Investigations and Litigation
September 20, 2022 | Rivkin Rounds Staff | False Claims Act | Fraud and Abuse | Litigation | Pharmaceuticals
Rivkin Radler’s Jeff Kaiser will be a panelist at the Upstate New York Health Care Fraud Symposium hosted by the United States Attorney’s Office for the Northern District of New York. Jeff’s panel is entitled “Use of the False Claims Act in Health Care Fraud Investigations and Litigation.” The symposium…
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Pharmacy Owners Charged for Fraud and Kickbacks to a Marketing Company
September 19, 2022 | Ada Janocinska | Uncategorized
The U.S. Department of Justice recently announced that a federal grand jury has charged two pharmacy owners, a mother-daughter duo from South Florida, with healthcare fraud, wire fraud, and payment of kickbacks in exchange for patient referrals. According to the indictment, the pharmacy entered into sham contracts with marketing and…
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NJ Publishes Guidance on Cannabis Sales & Use Tax and Social Equity Excise Fee
September 19, 2022 | Rivkin Rounds Staff | Cannabis | Legislation and Public Policy
The New Jersey Division of Taxation recently provided guidance on registration and licensing requirements, Social Equity Excise Fees, and the Sales & Use tax applicable to companies operating in the cannabis industry. This article by Rivkin Radler’s Louis Vlahos and Timothy Gonzalez summarizes important takeaways from the Division’s publication. Sign…
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Dental Care Alliance Settles Cyberattack Lawsuit for $3 Million
September 07, 2022 | Mary Connolly | Cybersecurity | Dentistry | Electronic Health Records | Litigation
Dental Care Alliance, LLC (DCA) agreed to settle a class action lawsuit that arose out of a 2020 cyberattack. A hearing to approve the $3 million settlement was held on September 1. DCA, based in Sarasota, Fla., is a dental services organization that provides practice support to over 390 affiliated…
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Dermatology Practice Settles Alleged HIPAA Violations
September 02, 2022 | Mary Connolly | HIPAA | Litigation
On August 23, the U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) announced that Massachusetts-based New England Dermatology, P.C., d/b/a New England Dermatology and Laser Center (NEDLC), agreed to resolve alleged HIPAA violations for a fine of $300,640. OCR commenced an investigation of NEDLC after the…
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As Telemedicine Expands, Insurance Fraud Grows
September 02, 2022 | Rivkin Rounds Staff | Fraud and Abuse | Litigation | Medicare and Medicaid | Telehealth
Rivkin Radler’s Michael Sirignano authored an article for the September 2 issue of the New York Law Journal entitled “As Telemedicine Expands, Insurance Fraud Grows.” The article discussed recent enforcement actions by the U.S. Department of Justice and the recent Special Fraud Alert issued by the U.S. Department of Health…
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Conducting HIPAA Breach Assessments and Disclosures: Requirements and Tips for Success
September 01, 2022 | Rivkin Rounds Staff | Cybersecurity | Electronic Health Records | HIPAA | Legislation and Public Policy
In the next installment of Rivkin Radler’s Healthcare Compliance Lunch & Learn series, Ashley Algazi will discuss requirements and tips for success in conducting HIPAA breach assessments and making required disclosures. The program will: • Review HIPAA breach definition • Discuss the analysis and investigation process to determine whether a…
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Fraud Week: Optical Lens Maker Reaches Kickback Settlement
August 27, 2022 | Eric Fader | False Claims Act | Fraud and Abuse | Legislation and Public Policy | Medicare and Medicaid
On August 23, the U.S. Department of Justice announced that Dallas-based optical lens manufacturer Essilor International and its affiliates agreed to pay $16.4 million to settle alleged violations of the federal Anti-Kickback Statute (AKS). Three former Essilor district sales managers filed a whistleblower suit under the False Claims Act claiming…
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Fraud Week: More Non-Existent Services
August 25, 2022 | Eric Fader | Fraud and Abuse | Litigation | Medical Devices and Wearables | Medicare and Medicaid | Private Insurers
If our most recent Fraud Week post (NY Chiropractor Billed for Non-Existent Acupuncture Services) didn’t already drive home the point, it is worth emphasizing that billing insurers for items or services that weren’t actually provided is always a bad idea. On August 4, the U.S. Department of Justice (DOJ) announced…
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OIG Concludes that $25 Patient Gift Card Presents Low Risk of Fraud and Abuse
August 24, 2022 | Ada Janocinska | Fraud and Abuse | Legislation and Public Policy | Medicare and Medicaid
The U.S. Department of Health and Human Services’ Office of Inspector General (OIG) recently issued an Advisory Opinion on offering gift cards to patients for completing an online patient education program. In this particular case, the online program was used to educate patients on the risks, benefits and expectations relating…
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Fraud Week: NY Chiropractor Billed for Non-Existent Acupuncture Services
August 23, 2022 | Eric Fader | Fraud and Abuse | Litigation | Private Insurers
On August 15, the U.S. Department of Justice (DOJ) announced that a Long Island chiropractor pleaded guilty to healthcare fraud for billing a private insurance company over $1 million for acupuncture services that were never performed. The investigation of Peter Adamczak was a joint effort by DOJ, the New York…
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Fraud Week: Unlucky Pharmacist
August 23, 2022 | Eric Fader | Fraud and Abuse | Litigation | Medicare and Medicaid | Pharmaceuticals | Telehealth
Rivkin Rounds’ first Fraud Week kicks off with kickbacks. The U.S. Department of Justice (DOJ) recently announced that the owner of Boerne Drug in Boerne, Texas was indicted on conspiracy charges for his role in an alleged kickback scheme. According to DOJ, pharmacy owner Lucky S. Ott and his co-conspirators…
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Employer Alert: First Deadline to Claim NYS Healthcare Worker Bonus is September 2
August 17, 2022 | Ada Janocinska | Behavioral Health | COVID-19 | Employer/Employee | Hospitals | Legislation and Public Policy | Medicare and Medicaid | Nursing Homes
As part of its 2023 state budget, New York State has allocated $1.2 billion for the payment of bonuses to certain frontline healthcare workers. This bonus program is intended to reward healthcare workers for their services during the COVID-19 pandemic and to promote employee retention and recruitment in the healthcare…
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Kaiser to be PLI Panelist on Drug and Device Enforcement Trends
August 12, 2022 | Rivkin Rounds Staff | False Claims Act | Fraud and Abuse | Legislation and Public Policy | Litigation | Medical Devices and Wearables | Medicare and Medicaid | Pharmaceuticals
On September 28, Rivkin Radler’s Jeff Kaiser will be a panelist at the Practising Law Institute’s program, Life Sciences 2022: Navigating Legal Challenges in Drug and Device Industries. The program is designed for attorneys and allied professionals who counsel pharmaceutical and life sciences companies. Entitled “Enforcement Trends Impacting the Drug…
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Private Insurers Must Watch Out for Medical Equipment Fraud
August 11, 2022 | Rivkin Rounds Staff | Fraud and Abuse | Litigation | Medical Devices and Wearables | Medicare and Medicaid | Private Insurers
Healthcare fraud related to durable medical equipment (DME) is extremely costly to insurers, yet often continues without criminal or civil consequences. Rivkin Radler’s Michael Vanunu recently wrote an article on the topic for Law360. Sign up to receive Rivkin Rounds at www.RivkinRounds.com. Continue Reading
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NY Medical Practice Settles False Claims Act Allegations Related to “Incident-To” Billing
August 08, 2022 | Mary Connolly | False Claims Act | Fraud and Abuse | Litigation | Medicare and Medicaid
On August 3, North Country Neurology, P.C., a physician-owned medical practice located in Watertown, NY (the “Practice”), reached a settlement with the U.S. Attorney’s Office for the Northern District of New York to pay $850,000 for submitting false Medicare claims for payment. Among other things, the Practice admitted to having…
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Spinal Device Distributor, Owners and PODs Settle Kickback Claims for $1 Million
July 27, 2022 | Eric Fader | False Claims Act | Fraud and Abuse | Litigation | Medical Devices and Wearables | Medicare and Medicaid
The U.S. Department of Justice (DOJ) recently announced that Reliance Medical Systems LLC, a Utah-based distributor of spinal implant devices, two of its individual owners, and two of its physician-owned distributorships (PODs) agreed to pay $1 million to resolve a lawsuit brought under the False Claims Act. Reliance allegedly operated…
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HHS OIG Issues Telehealth Fraud Alert
July 26, 2022 | Eric Fader | Fraud and Abuse | Litigation | Medicare and Medicaid | Telehealth
On July 20, the U.S. Department of Health and Human Services’ Office of Inspector General (OIG) issued a Special Fraud Alert to caution healthcare practitioners who may wish to enter into arrangements with telehealth companies. The Alert describes several types of fraud schemes that have resulted in federal investigations and…
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Amazon to Acquire One Medical for $3.9 Billion
July 22, 2022 | Rivkin Rounds Staff | Telehealth | Uncategorized
On July 21, Amazon confirmed that it intends to acquire One Medical for approximately $3.9 billion in an all-cash transaction. One Medical is a membership-based, technology-driven, primary care and telehealth organization with about 767,000 members as of the end of March 2022. The deal strengthens Amazon’s growing connections to the…
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HHS Renews COVID-19 Public Health Emergency Again
July 21, 2022 | Eric Fader | COVID-19 | Legislation and Public Policy | Medicare and Medicaid | Telehealth
On July 15, U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra formally extended the COVID-19 public health emergency for another 90 days. The PHE, which originally went into effect in January 2020, provides important flexibilities for healthcare providers, including expanding the types of telehealth services that are…
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University Health Center Pays $875,000 in HIPAA Fines after Cyber Hack
July 19, 2022 | Ada Janocinska | Cybersecurity | Electronic Health Records | HIPAA | Litigation
Oklahoma State University’s Center for Health Services recently paid $875,000 to settle potential HIPAA violations after a cyberattack resulted in the unauthorized access of its patients’ protected health information. A hacker installed malware on the Center’s web server which contained electronic protected health information. More than 275,000 individuals were affected…
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Transparency in Coverage Final Rule Took Effect on July 1
July 18, 2022 | Mary Connolly | Affordable Care Act | Legislation and Public Policy | Pharmaceuticals | Private Insurers
The Centers for Medicare & Medicaid Services’ Transparency in Coverage Final Rule took effect on July 1, following a six-month delay in implementation to allow payers to come into compliance. The Final Rule requires group health plans and health insurance issuers offering non-grandfathered coverage in the group and individual markets…
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New OMIG Compliance Regulations: What You Need to Know
July 13, 2022 | Rivkin Rounds Staff | Fraud and Abuse | Legislation and Public Policy | Medicare and Medicaid
On July 13, the New York Office of Medicaid Inspector General (OMIG) published proposed regulations implementing 2020 changes to law relating to provider compliance programs, Medicaid managed care fraud, waste and abuse prevention programs, and OMIG’s self-disclosure program. The proposed changes will significantly affect both payers and providers alike. In…
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