Vasilios J. Kalogredis

January 23, 2023 | The Legal Intelligencer

CMS provides direction and technical guidance for the administration of the federal effort to plan, develop, manage, and evaluate health care financing programs and policies, and OIG promotes changes that help CMS to improve such programs. Some of this is done through the annually published recommendations. In this article I provide highlights of what I believe are the most notable recommendations of this year's edition.

By Vasilios J. Kalogredis

8 minute read

October 31, 2022 | The Legal Intelligencer

Dozens of investigations conducted by OIG revealed various fraud schemes utilized by such telemedicine companies.

By Vasilios J. Kalogredis

7 minute read

October 03, 2022 | The Legal Intelligencer

On Aug. 18, the Centers for Medicare & Medicaid Services (CMS), the federal agency within the U.S. Department of Health and Human Services (HHS) that administers the Medicare program as well as works with states to administer Medicaid, the Children's Health Insurance Program (CHIP), and health insurance portability standards, announced a cross-cutting initiative aimed at evaluating CMS-issued public health emergency blanket waivers and flexibilities.

By Vasilios J. Kalogredis

8 minute read

August 01, 2022 | The Legal Intelligencer

The court's decision will protect patient access to prescriptions written in good faith. However, for the government, the court's decision means prosecutors face an uphill battle in charging, much less convicting, physicians under the CSA.

By Vasilios J. Kalogredis

5 minute read

July 01, 2022 | The Legal Intelligencer

In June, the U.S. Department of Health and Human Services Office of Inspector General (OIG) released Report No. A-07-18-02815 summarizing OIG's findings of an audit assessing the discrepancy in Medicare payments to provider-based facilities versus freestanding facilities in calendar years 2010 through 2017 in eight selected states.

By Vasilios J. Kalogredis and Rachel E. (Lusk) Klebanof

5 minute read

May 27, 2022 | The Legal Intelligencer

On April 28, the Office of Inspector General (OIG) for the U.S. Department of Health and Human Services issued an advisory opinion (No. 22-09) declining to approve a laboratory company's proposal to pay hospitals a fair market value, per-patient-encounter fee to collect, process and handle specimens.

By Vasilios J. Kalogredis and Rachel E. (Lusk) Klebanoff

6 minute read

April 25, 2022 | The Legal Intelligencer

Earlier this month, the Health Resources and Services Administration (HRSA) announced that it planned to reopen the Provider Relief Fund (PRF) reporting period after thousands of recipients were asked to return the money for missing the deadline back in September.

By Vasilios J. Kalogredis and Rachel E. (Lusk) Klebanoff

5 minute read

March 31, 2022 | The Legal Intelligencer

Physician groups should be aware of the broad applicability of the New Jersey Codey Law as it applies to referrals to entities that a practitioner has an interest in, and structure (or reevaluate) their practices and businesses accordingly.

By Vasilios J. Kalogredis and Rachel E. (Lusk) Klebanoff

5 minute read

February 24, 2022 | The Legal Intelligencer

By entering into the CIA, a provider or entity agrees to various obligations in exchange for the OIG's agreement that it will not seek to exclude the provider or entity from participation in Medicare, Medicaid or other federal health care programs.

By Vasilios J. Kalogredis and Rachel E. (Lusk) Klebanoff

6 minute read

November 29, 2021 | The Legal Intelligencer

When a patient gets care from an OON provider, their health plan or issuer usually does not cover the entire OON cost, leaving the patient with higher out-of-pocket costs than if they have been seen by an in-network provider.

By Vasilios J. Kalogredis and Rachel E. (Lusk) Klebanoff

8 minute read