October 31, 2022 | The Legal Intelligencer
OIG Issues Fraud Alert for Practitioners Working With Telehealth CompaniesDozens 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
CMS Issues Guidance—Creating a Roadmap for the End of COVID-19 Public Health EmergencyOn 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
SCOTUS Sides With Doctors Convicted of Running 'Pill Mills'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
Report: Medicare Payment Discrepancies Seen Between Provider-Based and Freestanding FacilitiesIn 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
OIG Declines to OK Lab's Proposed Payment of Specimen Collection Fees to HospitalsOn 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
HRSA to Reopen Provider Relief Fund Reporting After Clawback ThreatEarlier 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
NJ Court Affirms Codey Law Prohibiting Physicians From Opening PharmaciesPhysician 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
Understanding Health Care Corporate Integrity AgreementsBy 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
'Surprise Billing' to End January 2022 With the No Surprises ActWhen 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
November 01, 2021 | The Legal Intelligencer
New Stark Law Requirements Will Modify Certain 'Group Practice' Compensation MethodologiesThese changes revise the rule related to "overall profits" to prohibit pooling and distributing profits or productivity bonuses from designated health services (DHS), such as in-office laboratory or imaging services, on a service-by-service basis. This practice is sometimes referred to as "split pooling."
By Vasilios J. Kalogredis and Rachel E. (Lusk) Klebanoff
6 minute read
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