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HHS-OIG Launches On-Line Platform to Submit Self-Disclosures

Posted on Health Care Law News July 8, 2013 by author

Earlier today, the OIG launched an online submission process for its voluntary Self-Disclosure Protocol. This online disclosure tool is designed to make it even easier for providers who wish to voluntarily disclose self-discovered evidence of potential fraud to OIG. According to the OIG’s associated press release, “Self-disclosure gives providers the opportunity to avoid the costs Read more →

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Medicaid Data Mining Coming to a State Near You

Posted on Health Care Law News May 20, 2013 by author

On May 17, 2013, HHS published a rule change that will allow state Medicaid programs to use federal funds to data mine for erroneous and false claims. The rule change is expected to generate an estimated $60 million in additional recoveries over the next decade. In order to obtain a portion of the approximately $12 Read more →

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CMS Makes Payment Processing Edit to Reduce Erroneous New Patient E&M Charges

Posted on Health Care Law News May 19, 2013 by author

In order to avoid erroneous billing practices for “New Patient” Evaluation and Management services, CMS issued Change Request 8165 which informs Medicare contractors about changes to Medicare’s Common Working File system that detects errors in billing.  According to Medicare manuals, “New Patient” is defined as: a patient who has not received any professional services, i.e., Read more →

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CMS Issues Rule Regarding Reporting of Physician Payments from Drug and Device Manufacturers

Posted on Health Care Law News May 19, 2013 by author

On February 8, 2013, CMS issued a final rule intended to increase public awareness of financial relationships between manufacturers of drugs, devices, biological and medical supplies.  The rule also seeks to reveal relationships between Group Purchasing Organizations (GPOs), and physician and teaching hospitals.  The final rule, titled: “Medicare, Medicaid, Children’s Health Insurance Programs; Transparency Reports Read more →

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Fourth Circuit Court of Appeals Clarifies What “Protected Activities” Are Under a FCA Retaliation Claim

Posted on Health Care Law News May 11, 2013 by author

In Glynn v. Edo Corp., 710 F.3d 209 (4th Cir. 2013), the Fourth Circuit recently clarified what constitutes “protected activity” under the anti-retaliation provision of the False Claims Act, 31 U.S.C. § 3730 (h)(1). As background, to prove a FCA retaliation claim, a whistleblower must show, inter alia, that he was engaged in “protected activity” Read more →

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