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)…
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…
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…
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…
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…
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…
From July 2011 to February 2012 the Government Accountability Office (GAO) conducted a performance audit of the Centers for Medicare and Medicaid Services (CMS) efforts to strengthen the screening of providers and suppliers applying to take part in, and currently taking part in, the Medicare and Medicaid programs. On April…
On April 2, 2012 DCS Healthcare posted new approved issues to its approved issues list for some Region A states. Among them were two issues for skilled nursing facilities: · CT Scans, Head and Neck, Incorrect Billing: Potential incorrect billing of CT scans not supported by medical necessity (NGS LCD…
The Centers for Medicare and Medicaid Services (CMS) issued a memo to Medicare Shared Savings Program (MSSP) applicants on March 16, 2012, in response to questions from Accountable Care Organization (ACO) applicants. The memo clarified and provided guidance on some of the requirements ACO applicants to the MSSP will have…
The Centers for Medicare and Medicaid Services (CMS) has published a final rule for standards regarding Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) suppliers. The rule, published March 14, 2012 in the Federal Register, revises and specifies the definition of “direct solicitation” as it applies to DMEPOS suppliers. The…