Federal Court Finds That CMS Overpayment Rule Does Not Violate Medicare Requirements
Key Points: The D.C. Circuit Court of Appeals has reversed a lower court opinion that vacated the Center for Medicare…
DOJ Intervenes in Whistleblower Suits Against Kaiser Permanente
Six complaints allege submission of inaccurate diagnosis codes. The Department of Justice (DOJ) intervened in multiple whistleblower complaints alleging that…
Bipartisan Group of Senators Proposes Amendments to False Claims Act
Key Points: Amendments would result in significant modifications to statutory language. Burden of justifying dismissal of cases would be codified.…
DOJ Reports Sentencing of Two Physicians to Prison for Prescription Fraud
The United States Department of Justice (DOJ) announced that two Arkansas physicians were sentenced to a combined 12 and a…
CMS Lacks Consistent Oversight of Networked Device Cybersecurity in Hospitals
The OIG recommends that CMS address cybersecurity of networked medical devices in its quality oversight of hospitals. Networked medical devices…
Millions of Dollars in Overpayments Identified for ESRD Monthly Capitation Payments
CMS claims processing controls were inadequate. An audit conducted by the Department of Health and Human Services Office of the…
The Scripps Health 2021 Ransomeware Attack
Key Points: Scripps Health (Scripps), a health system based in San Diego, was subject to a cyberattack in which unauthorized…
One Billion CVS Records Accidentally Posted Online
Earlier this year, an independent cybersecurity researcher discovered that a CVS Health database containing more than 1 billion data points was posted…
More Than 40% of Medicare Beneficiaries in Nursing Homes May Have Developed COVID-19 in 2020
OIG report confirms COVID-19’s devastating impact on Medicare beneficiaries in nursing homes. A study of Medicare claims data by the…
OIG Issues Semiannual Report
Key Points: $566.46 million in expected recoveries from audit results. $1.37 billion in expected investigative recoveries. 221 criminal actions. 272…
Hacking Incidents Skyrocketed During the COVID-19 Pandemic
Hacking Incidents Increased by 42 Percent A report by Protenus, Inc. indicates that that while hacking incidents in the health care industry…
Criminal Charges Related to COVID-19 Pandemic Brought Against Defendants Across the Country
Telemedicine Executive, Physician, Marketers, and Medical Business Owners Charged in Fraud Schemes Involving $143 Million in Losses. The Department of…