Category Archives: General

Combined DOJ/HHS Fraud Crackdown in 7 Cities Across the Country Nets 107 Suspects for $452 Million in Fraudulent Billing

Posted on May 4, 2012 by | Comments Off

On May 2, 2012, the US. Department of Justice and the U.S. Department of Health and Human Services announced that its combined law enforcement agencies, as part of the Medicare Fraud Strikeforce, rounded up 107 suspects for fraudulent Medicare billing.  These 107 suspects are responsible for $452 million dollars of billing in multiple areas of health care including mental health services, and durable medical equipment and supplies.  More than 500 law enforcement agents were involved in the fraud crackdown from FBI, HHS-Office of Inspector General (OIG) and  multiple state Medicaid Fraud Control Units.  Physicians, nurses, suppliers and owners were included in the list of person that were arrested in the raids.  The seven cities where suspects were arrested were included Miami, detroit, Chicago, Houston, Los Angeles, Tampa and Baton Rouge.

These significant fraud enforcement activities represent the new “normal” as Federal and State government agencies combine resources and use very sophisticated data analytics tools aimed at finding and fighting Medicare fraud.

More detailed information is available at the Office of the Inspector General’s website at www.oig.hhs.gov and you can find a press release on the Department of Justice Website here  —> DOJ Pres Release.

For more information on the Medicare Strike Force or regulatory enforcement in general, please feel free to contact Janet Feldkamp or any member of our health care practice group.

Comments Off

Posted in DHHS, Fraud and Abuse, General, Health & Human Services, Health Care, Health Care Providers, Medicare, OIG, Program Integrity, Regulatory Compliance

DHHS IG, Daniel Levinson Advises at HCCA that Fraud Enforcement Recovers 7 Dollars for Every Dollar Spent

Posted on May 4, 2012 by | Comments Off

Daniel R. Levinson, the Inspector General of the U.S. Department of Health and Human Services (“OIG’”) gave a keynote presentation at the Health Care Compliance Association’s 2012 Compliance Institute this past week.

The presentation was full of interesting details and issues relating to how the OIG and IG Levinson approach fraud and abuse enforcement. Below are some highlights of IG Levinson’s presentation.

The OIG’s ROI

IG Levinson reminded the audience of the significant return on investment the government gets from its fraud fighting efforts. According to IG Levinson, the government now recovers an average of 7 dollars for every dollar spent on its fraud fighting efforts. In his discussion, he pointedly remarked on how these statistics continue to show the significance of fraud in the health care system. Continue reading →

Comments Off

Posted in Anti-Kackback, Compliance Programs, DHHS, Exclusion, Fraud and Abuse, General, Health & Human Services, Health Care, Health Care Providers, Medicaid, Medicare, OIG, Regulation, Regulatory Compliance

Benesch Health Care Attorney Published in AHLA’s HIT News

Posted on April 19, 2012 by | Comments Off

Frank Carsonie, Chair of our Health Care Practice Group, co-authored the article Reducing Risk in the Electronic Implementation of Electronic Records Systems: Practical Considerations and Benefits of a Risk Assessment in the March 2012 issue of HIT News published by the American Health Lawyer’s Association. Frank co-authorized the article with John DiMaggio, CEO of MCS2 Solutions, a veteran in the area of health care information technology solutions and privacy and security protections. The article provides a road map for organizations considering risk assessments for compliance with HIPAA and discusses some of the more common obstacles to completing a meaningful risk assessment and fully deploying a risk management plan.

The HIT Newsletter article* by Frank and John can be viewed here.

*Copyright 2012 American Health Lawyers Association, Washington, DC  Reprint permission granted.

Comments Off

Posted in Consumers, DHHS, General, Health Care, Health Care Providers, Health Information Technology, HIPAA, Medicaid, Medicare, Patient Privacy, Regulatory Compliance

Top 10 Hospice Survey Deficiencies According to CMS at the NHPCO MLC 2012

Posted on April 4, 2012 by | 1 Comment

Representatives of CMS’ Survey and Certification Group provided valuable insight into the top 10 survey citations/deficiencies for hospice providers at the National Hospice and Palliative Care Organization’s, 27th Annual Management and Leadership Conference last week. The informative session discussed survey deficiencies,  the implementation of quality measures as well as CMS’ efforts to reform the hospice reimbursement system. Understanding the top 10 survey deficiencies is an important part of planning overall regulatory compliance initiatives and day to day operations. The top ten citations relate broadly to the areas of care planning, supervision and training of employees, and the provision of certain counseling services. Continue reading →

→ 1 Comment

Posted in Certification, Compliance Programs, General, Health & Human Services, Health Care, Health Care Providers, Hospice, Medicare, Palliative Care, Participation, Regulation, Regulatory Compliance

Tagged