With the rise of the health-related mobile application market, the Food and Drug Administration (FDA) proposed its first-ever regulations on the industry. The regulations target three types of applications that require the FDA’s approval: an application that acts as an accessory to a regulated medical device, turns the mobile technology…
Wachler & Associates Health Law Blog
Proposed Rule Requires Face-to-Face Encounter for Medicaid Home Health Beneficiaries
The face-to-face requirements for Medicaid home health services will follow a similar timeframe to that set forth for Medicare. The timeframes were established by the Patient Protections and Affordable Care Act (PPACA), and CMS intends to enforce the regulation. A proposed rule creates the requirement that physicians document the existence…
Patient Sues Tufts Medical Center for Violating Her Privacy Rights
According to a Boston Globe article, Tufts Medical Center and one of its primary care doctors are being sued by a patient whose privacy rights were allegedly violated when her medical history was sent to a fax machine at her workplace without her consent. The patient, Kimberly White, was recovering…
Detroit Clinic Owner Sentenced to 27 Months in Prison for Medicare Fraud
A Miami resident and Detroit clinic owner, Arnaldo Rosario, was recently sentenced to 27 months in prison for his role in recruiting patients to three clinics in the Detroit area. According to the FBI, the Medicare fraud scheme involved remuneration to Medicare beneficiaries for visiting the clinics and fraudulently representing…
CMS Releases 3rd Quarter Summary of Medicare FSS RAC Recoveries
The Centers for Medicare and Medicaid Services (CMS) has posted a summary of the Medicare Fee for Service RAC recoveries for the 3rd quarter of fiscal year 2011. The summary displays the amount of each region’s overpayments, underpayments and total corrections, as well as the nationwide totals. In addition to…
HHS Suspects Nursing Homes may be Committing Medicare Fraud
Health and Human Services (HHS) Office of the Inspector General (OIG) has reported that skilled nursing facilities (SNFs) may be a possible suspect for receiving fraudulent Medicare payments. Auditors for HHS have discovered that many nursing homes are collecting Medicare payments that are much higher than the national average. For…
GAO Report Finds CMS’ Systems to Detect Fraud ‘Inadequate and ‘Underused’
Despite the large number of Medicare and Medicaid audits and investigations currently being conducted by government contractors, the Government Accountability Office (GAO) recently released a report stating that the federal government’s systems for analyzing Medicare and Medicaid data to detect fraud are “inadequate and underused.” In 2009, CMS enacted new…
CMS to Release Comparative Billing Reports for Physicians Ordering Spinal Orthotic Devices
The Centers for Medicare and Medicaid Services (CMS) recently announced it will release a national provider Comparative Billing Report (CBR) this July. CMS will release 5,000 CBRs to physicians ordering spinal orthotic devices billed to Medicare. The CBRs are produced by Safeguard Services under contract with CMS and will provide…
OIG Concerned About the Rising Costs of Hospice Care
In collaboration with Kaiser Health News, the New York Times recently reported on the concerns over the rising costs associated with hospice care. While Medicare is praised for its reimbursement of providers for hospice services because of the medical and emotional support hospice gives to dying patients, there are concerns…
Recently Released Medical Marijuana Memo Contradicts Obama Administration’s Policy Not to Interfere with State Law
In contradiction of President Obama’s campaign promises to let states create their own policies regarding medical marijuana use, the Obama administration released a memo approving federal prosecution of anyone in the business of cultivating or supplying marijuana to patients, whether or not they comply with state law. The original guidelines…