The final rule changed several elements from the proposed rule. One changed feature under the final rule is that one entity will be responsible for testing EHRs, and another entity will be responsible for certifying the EHRs. No single entity will be allowed to perform both activities. Other changes involve…
Due to confusion surrounding whether an IDTF was considered a “mobile” or “fixed-base” delivery structure, the DAB has explicitly stated that there are two types of mobile IDTFs. Mobile IDTFs can either be “portable units” or a “mobile facility or unit.” The difference between the two definitions is that a…
The Adminstration has increased fraud prevention spending to $1.7 billion during the past fiscal year, a substantial increase from previous years. This increase has been used to combat the estimated $60 billion lost to fraud in any given year. The funds are going towards new law enforcement intra-agency teams called…
Time Magazine published an article on January 4 outlining the Federal Government’s increased measures to combat Medicare fraud. The article outlined that although there is not an official figure on the cost of government health program fraud, the National Health Care Anti-Fraud Association estimates that it is at least $60…
Andrew Wachler, principal of Wachler & Associates, P.C., was quoted in today’s Detroit Free Press regarding the Detroit Medical Center’s (DMC) $30 million settlement with the Federal government for violations of the Anti-Kickback Statute and Stark for improper financial relationships with referring physicians. Mr. Wachler stated that the DMC case…
The Department of Health and Human Services Office of Inspector General (OIG) released an unfavorable Advisory Opinion involving a transportation supplier’s proposal to offer skilled nursing facilities (SNFs) two payment plans for transportation of the SNF’s Medicaid-covered residents. The OIG determined that the arrangement could potentially violate the Anti-Kickback Statute…
The Detroit Free Press reported that the Detroit Medical Center has agreed to pay $30 million to the federal government to settle claims that involved violations of the Anti-Kickback Statute and Stark from improper financial relationships with referring physicians. The majority of the relationships at issue in the DMC matter…
The Department of Health and Human Services (HHS) Office of Inspector General (OIG) reported $25.9 billion of expected recoveries and savings in fiscal year (FY) 2010. The large amount is a combination of audit receivables, investigative receivables and other legislative and cost-saving actions that OIG recommended. In addition, the OIG’s…
Last week President Obama signed legislation that will delay Medicare payment cuts for one more year. The reduction in pay, 25 percent, had been scheduled to begin on January 1, 2011. The American Medical Association strongly advocated for the delay that is longer than the previous five delays over the…
The U.S. District Court for the Eastern District of Virginia ruled that Section 1501 of the Patient Protection and Affordable Care Act (PPACA) is unconstitutional. Shortly after PPACA was passed in March 2010, Virginia passed a state statute that conflicted with the individual mandate found in Section 1501 of PPACA…