Traits of Effective Healthcare Compliance Officers
Characteristics and Tips Industry guidance frequently calls for compliance officers to be effective. In the original Compliance Program Guidance for Hospitals,…
After Two Years of COVID-19 Crisis Management, Why Will 2022 Be the Right Time for a Compliance Program Evaluation?
Key Points: As health care organizations emerge from crisis management, leadership should consider refocusing on compliance. It is time to…
The Eight “Ps” for Effective Compliance Investigations
The following are eight guidelines to prevent poor outcomes when conducting compliance investigations. Policies. Developing and implementing written policies and procedures…
Opportunities for Oversight of Telehealth for Behavioral Health Services
States are not analyzing how telehealth affects behavioral health services nor monitoring for fraud, waste, and abuse. The results of…
$3 Million Settlement for Hospital Upcoding Allegations
Key Points: Whistleblower to receive nearly $1 million dollars. Improper bundling and upcoding described in whistleblower’s complaint. The Department of…
Reminder That COVID-19 Fraud and Related Schemes Still Abound
Key Points: DOJ and OIG continue to issue warnings about fraud schemes. Consumers should remain alert. The Department of Health…
New FBI Cybersecurity Warning
Tips to protect against cyberattacks. The Federal Bureau of Investigation (FBI) issued a cybersecurity alert calling for increased vigilance in network…
$160 Million Medicare Fraud Settlement for Diabetic Testing Supplier
Whistleblower to receive $28.5 million of recovery. The Department of Justice (DOJ) announced that Arriva Medical LLC (Arriva), which was once the…
CMS Has Insufficient Authority to Ensure Hospitals Are Prepared for Emerging Infectious Diseases
The Department of Health and Human Services Office of the Inspector General (OIG) conducted an audit to determine whether the Centers…
Federal Court Finds That CMS Overpayment Rule Does Not Violate Medicare Requirements
Key Points: Expect CMS to move against backlog held up by litigation. Expect an increase in DOJ investigative and enforcement…
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.…