Stark Law

CMS Proposes to Peel Back Restrictions on Physician Owned Hospital Expansions

From the onset, the Administration has assigned a high priority to loosening Stark Law and Anti-Kickback Statute (AKS) restrictions. And now CMS has floated two new proposals allowing for greater … [Read more...]

Feds Charge Silicon Valley Med Tech Executive with Massive COVID-19 Stockholder Swindle

The executive of a publicly traded Silicon Valley medical tech firm has been charged with swindling investors and insurers by misrepresenting the diagnostic capabilities of a test using finger stick … [Read more...]

Cybersecurity

OCR Temporarily Eases HIPAA Privacy Restrictions for Telehealth Practice

In furtherance of its social distancing strategy, the federal government is temporarily allowing labs and other health care providers to use communication technologies like Facetime or Skype for any … [Read more...]

CMS Increases 2020 Maximum Civil Monetary Penalties

Every year, HHS adjusts for inflation the maximum civil monetary penalty (CMP) amounts that a lab or other provider can be fined. In 2020, CMP maximums will increase by 2.522%. The new higher CMP … [Read more...]

Enforcement Trends: OCR Continues to Crack Down on HIPAA Right of Access Violations

On Sept. 9, 2019, the Office for Civil Rights (OCR), the HHS agency in charge of federal HIPAA enforcement, did something it had never done before by entering into a monetary settlement with a … [Read more...]

ENFORCEMENT

Enforcement Trends: False Claims Act Recoveries Increase as Labs Remain in Firing Line

The dollars paid by healthcare providers in federal False Claims Act settlements and judgments increased for the second year in row in 2019. After a surprising decline in 2017, total recoveries … [Read more...]

ENFORCEMENT

Enforcement Trends: The Top 5 Lab False Claims Act Settlements of 2019

Labs were on the paying end of at least eight million-dollar False Claims Act (FCA) settlements or judgments in the 2019 fiscal year. Here’s a review of the top 5 reported FCA recoveries against a lab … [Read more...]

In Brief: OIG Opens Second Avenue for Anti-Kickback Statute Revisions

Even as we wait for the second draft of the proposed new value-based kickback relief rules—see National Intelligence Report (NIR), Nov. 15, 2019—the OIG issued its annual call for recommendations for … [Read more...]

ENFORCEMENT

Enforcement Trends: Increase in OIG Fraud Recoveries Belies Continued Decline in Enforcement Actions

OIG fraud recovery has been a solid growth business for nearly two decades. So, when the agency announced a decline in FY 2018 recovery figures, it was more than a bit surprising. But things got back … [Read more...]

OIG

Scorecard: OIG Enforcement Actions against Labs in 2019

Labs remain at the top of the OIG’s enforcement hit list, as illustrated by the number of cases involving labs cited in the agency’s new Semiannual Report to Congress for FY 2019: False Billing … [Read more...]


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