OIG Finds Excluded Individuals Employed by Medicaid Managed Care Entities
The Department of Health and Human Services Office of Inspector General (OIG) released a report concerning excluded individuals in Medicaid…
GAO Issues Report on Health Care Fraud and Abuse Investigations
The Government Accountability Office (GAO) recently issued a report on providers involved in Medicare, Medicaid, and Children’s Health Insurance Program…
Medicare Fraud Strike Force Charges 91 Individuals for Criminal Activities for Falsely Billing Medicare for $430 Million
Attorney General Eric Holder recently commended the Medicare Fraud Strike Force for their action against 91 individuals in seven states…
CMS Starts New Initiative to Reduce Avoidable Hospitalizations for Nursing Home Residents
The Centers for Medicare & Medicaid Services (CMS) recently launched the “Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents.”…
Massachusetts Provider Enters into a $1.5 Million Settlement with HHS for HIPAA Violations
Massachusetts Eye and Ear Infirmary and Massachusetts Eye and Ear Associates Incorporated (MEEI) settled with the Department of Health and…
New York Downtown Hospital Settles Allegations of Medicaid Fraud for $13.4 Million
The New York Attorney General’s Office recently settled with New York Downtown Hospital (NY Downtown Hospital) for $13.4 million following…
HHS Publishes Final Rule for a Unique Health Plan Identifier and to Delay ICD-10 Implementation.
The Department of Health and Human Services (HHS) recently published a final rule that will establish a unique health plan…
CMS Releases IPPS 2013 Final Rule
The Centers for Medicare & Medicaid Services (CMS) released the final rule on the hospital Inpatient Prospective Patient System (IPPS)…
HHS Issues Final Stage 2 Meaningful Use Requirements
The Department of Health and Human Services (HHS) released the meaningful use requirements for Stage 2 of the Electronic Health Records…
CMS Prepares to Launch the Recovery Audit Prepayment Reviews
The Centers for Medicare & Medicaid Services (CMS) recently launched the Recovery Audit Prepayment Review Demonstration on August 27, 2012,…
OMB Delays Final Rule for HIPAA Privacy and Security Regulations
The Office of Management and Budget (OMB) postponed publication of the Health Insurance Portability Accountability Act (HIPAA) Final Rule. OMB…
OCR’s Audit Protocol for the HIPAA Audit Program
The Department of Health and Human Services Office for Civil Rights (OCR) recently released the audit protocol that is used…