Close

Articles Posted in Compliance

Updated:

Congressional Committee Requests GAO Study of CMS Contractor Redundancies

Members of the United States House Energy and Commerce Committee sent a request on June 26, 2012 to the Government Accountability Office (GAO) requesting a study of redundancy in Centers for Medicare and Medicaid Services (CMS) contractor audits. The request included four specific questions that, at a minimum, the committee…

Updated:

Medicare Fraud Task Force Targets Psychotherapy Providers

The United States Department of Justice (“DOJ”) announced yesterday that a Detroit-area resident, Louisa Thompson, plead guilty on June 20, 2012, to one count of criminal conspiracy to commit health care fraud in the Eastern District of Michigan federal court. The Health Care Fraud Prevention and Enforcement Action Team (HEAT)…

Updated:

Congressional Subcommittee Hears OIG Testimony on Medicare Benefit Integrity Contractors

On June 8, 2012, Robert Vito, Regional Inspector General for Evaluation and Inspections at the U.S. Department of Health and Human Services (HHS), Office of Inspector General (OIG), testified before the House Energy and Commerce Committee: Subcommittee on Oversight and Investigations. The testimony focused on the current OIG assessment of…

Updated:

Federal District Court Overturns Part B Claim on Judicial Review

On May 29, 2012 the United States District Court for the Eastern District of North Carolina overturned the Medicare Appeals Counsel’s (MAC’s) decision regarding one evaluation and management (E/M) service claim. Six years earlier, a CMS Program Safeguard Contractor audited Dr. Ojebuoboh. It was determined that the government had overpaid…

Updated:

HHS Releases Memo to Consumers Highlighting HIPAA Rights to Access Health Records

On May 31, 2012, Department of Health and Human Services (HHS) Director of the Office of Civil Rights Leon Rodriguez issued a memo to consumers regarding those consumers’ right to access their protected health information and medical records. In this memo, Rodriguez stressed that it is important for consumers and…

Updated:

State AG HIPAA Training Materials Available Online

The Office of Civil Rights (OCR) announced yesterday that its Health Insurance Portability and Accountability Act (HIPAA) Enforcement Training tools would be available to the general public today, June 5, 2012. Since 2009, as part of the Health Information Technology for Clinical and Economic Health (HITECH) Act, State Attorneys General…

Updated:

Knowledge of Illegality Not Required For Criminal Charges Under HIPAA

On May 10, 2012 the United States Court of Appeals for the Ninth District decided that criminal charges under the Health Insurance Portability and Accountability Act (HIPAA) do not require that an individual have knowledge that their actions are illegal. The case, United States of America v. Zhou, is the…

Updated:

CMS Provides List of Providers Who Need to Revalidate Their Medicare Enrollment

As part of healthcare reform, Section 6401(a) of the Affordable Care Act requires all providers and suppliers who enrolled in the Medicare program prior to March 25, 2011 to revalidate their provider enrollment under the new screening criteria. Providers and suppliers who enrolled after March 25, 2011 do not need…

Updated:

CMS Delays Implementation of Physician Payments Sunshine Act

On May 3, 2012, the Centers for Medicare and Medicaid Services (CMS) announced, via the CMS blog, that CMS will not require data collection by applicable manufacturers and group purchasing organizations under the Physician Payments Sunshine Act (PPSA) before January 1, 2013. The announcement indicates that the final rule will…

Updated:

CMS Publishes Final Rule With New Provider and Supplier Requirements

On April 27, 2012 the Centers for Medicare and Medicaid Services (CMS) published a final rule that states new provider and supplier requirements. The final rule requires all providers and suppliers that qualify for a National Provider Identifier (NPI) to include their NPI on all enrollment applications for Medicare or…

Call Us