On November 6, 2023, the HHS Office of Inspector General published a new compilation of compliance guidance under the title General Compliance Program Guidance (GCPG) for the healthcare compliance community
Continue Reading In Case You Missed It: New OIG General Compliance Program GuidanceTwo landmark cases fraught with False Claim Act (“FCA”) allegations of fraudulent billing for prescription drugs against food and pharmacy chains are making their way from the Seventh Circuit to
Continue Reading Is it Really Fraud? The Supreme Court Will DecideThe Department of Justice’s continued focus on prosecuting fraud related to pandemic relief programs has resulted in a new batch of criminal charges, convictions and penalties for those who have
Continue Reading The Federal Government’s Continued Focus on COVID-19 Aid Fraud Leads to New Charges, Convictions and Sentencings
On the heels of the Supreme Court decision in Xiulu Ruan v. United States, wherein the Supreme Court held that the government must prove beyond a reasonable doubt that
Continue Reading Creation of New Opioid Strike Force, Following Decision in Xiulu Ruan v. US, Signals Investigations of Physicians Will IntensifyA nationwide telemedicine kickback scheme led to fraudulent Medicare reimbursements for durable medical equipment and genetic testing. The full Department of Justice press release can be found here.
Continue Reading Georgia Nurse Pleads Guilty to Telemedicine Fraud Scheme
A recent health care fraud conspiracy case resulted in federal prison sentences for six participants, serving as a warning to pharmacy owners and their employees. Read the full Department of
Continue Reading $8 Million Pharmacy Fraud Case Lands 6 Behind Bars
On October 2, 2020, Health and Human Services (HHS) Secretary, Alex M. Azar II, announced the renewal of the public health emergency declaration due to the continued consequences of the
Continue Reading HHS Extends COVID-19 Related Public Health Emergency through January 20, 2021
Medical record requests by payors are commonplace for health care providers. Typically, these requests are received by a front desk employee who responds to the inquiry in short order. Yet,
Continue Reading THE ABC’S OF THE S.I.U.: What Providers Need to Know
CMS recently issued an Advisory Opinion suggesting that physicians who refer diagnostic tests reimbursable under Medicare to a laboratory may, under certain circumstances, receive electronic pop-up notifications in the laboratory’s
Continue Reading CMS Provides Advice on Electronic Laboratory Alerts
The Office of Inspector General (“OIG”) of the Department of Health and Human Services, generally, would have concerns about a potential or existing referral source receiving free goods or services,
Continue Reading OIG Okays Free Vaccine Dispensing System for Physician Office Use