DOJ and CMS Investigate Large Oncology Provider for Fraud.
The Department of Justice (DOJ), the Centers for Medicare and Medicaid Services (CMS) and several additional federal agencies have recently…
DOJ Reports on Sentencing for Former Tufts Health Plan Employee Who Disclosed PHI.
The Department of Justice (DOJ) recently reported that a former Tufts Health Plan employee was sentenced in federal court for…
CMS Readies Fraud Prevention Initiative to Issue New Medicare Beneficiary Cards by April 2019.
The Centers for Medicare and Medicaid Services (CMS) is readying a fraud prevention initiative that removes Social Security numbers from…
DOJ Announces $34 Million False Claims Settlement with Two Missouri Hospitals.
The Department of Justice (DOJ) recently announced their false claims settlement with two southwest Missouri health care providers. Mercy Hospital…
OCR Announces $2.4 Million HIPAA Settlement with Memorial Hermann Health System.
The Department of Health and Human Services (HHS) Office for Civil Rights (OCR) recently reported on their compliance review of…
OCR Announces HIPAA Settlement for Careless Handling of HIV Information.
The Department of Health and Human Services (HHS) Office for Civil Rights (OCR) recently reported that St. Luke’s-Roosevelt Hospital Center…
Tips and Tools for Co-Sourcing Compliance Program Functions.
Compliance Officers are facing mounting regulatory and internal demands, while equipped with inadequate resources to meet all of these challenges.…
Massachusetts’s State Auditor Finds $193 Million in Improper Behavioral Health Payments by MassHealth.
Massachusetts’s State Auditor recently audited the behavioral health program at MassHealth. The audit found that MassHealth paid doctors directly for…
OIG Reports on CMS Oversight Weaknesses In Federal Marketplace.
The Department of Health and Human Services (HHS) Office of Inspector General (OIG) recently reported on the Federal Marketplace’s inability…
GAO Issues Report on CMS Oversight of Medicare Contractor’s Education to Providers.
The Government Accountability Office (GAO) recently released a report reviewing the Centers for Medicare and Medicaid Services’ (CMS) oversight of…
HHS Fails to Reduce Provider Appeals Backlogs.
The Department of Health and Human Services (HHS) recently reported to the Federal Court that they will be unable to…
Tips for using the OIG Provider Self-Disclosure Protocol.
The Department of Health and Human Services (HHS) Office of Inspector General (OIG) published the Provider Self-Disclosure Protocol (SDP) in…