Compliance Update

Healthcare Fraud Scheme Indictment Starts the New Year

The U.S. Attorney arrested 13 people in a $100 Million healthcare fraud scheme in NY and NJ involving automobile insurance claims. Some of the facts alleged include— Bribed 911 operators and hospital employees for confidential information of insured drivers Unnecessary and painful medical procedures A non-physician owning medical clinics Paying hundreds of thousands of dollars to “runners” who...

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The On-Again, Off-Again Vax Mandate

If those of us in healthcare are having a tough time keeping straight whether the mandates are on or off, imagine the rest of the country! As of this writing, they are on. Kind of. Feel free to read through an earlier blog and its information sources for a timeline, but in a nutshell, there are two mandates. OSHA’s ETS is aimed at employers with 100+ employees and requires both doses of the...

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No Surprise Billing Requirements to be Implemented Jan 1, 2022

On January 1, 2022, a new federal law, “Requirements Related to Surprise Billing, Part I” (“The Rule”), goes into effect for health care providers and facilities and for providers of air ambulance services. The Rule will restrict excessive out-of-pocket costs to consumers which resulting from surprise billing and balance billing. Group health plans and health insurers contract with a network of...

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OIG Revises Self-Disclosure Protocol

For the first time since 2013, The U.S. Department of Health & Human Services Office of Inspector General has issued updates to its Healthcare Fraud Self-Disclosure Protocol. Created in 1998, the protocol can be used to create a process to voluntarily identify, disclose and resolve instances of potential fraud involving federal healthcare programs. The OIG noted that between 1998 and 2020,...

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What Does the Law Say About Stem Cell Research?

Stem cell law has been heavily contested in the courts for decades in the United States, and the hotly debated topic has strong support on both sides. In fact, it is not just at the federal level that lawmakers have been unable to reach a decision. Each state has also fought through the different permutations of stem cell research law in its own courts, and decisions are continually being...

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OIG Gives Blessing to Alzheimer’s Study Payment Arrangement

On September 29, the U.S. Department of Health and Human Services Office of Inspector General issued a favorable advisory opinion regarding the proposed subsidization of certain Medicare cost-sharing obligations relating to a clinical study of Alzheimer’s disease. The requestor is a professional medical society that represents radiologists and a charity that provides support and research...

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