Page 48 - Program Integrity News Today

A bipartisan group of 50 Senators, led by Senator Brian Schatz introduced the Creating Opportunities Now for Necessary and Effective Care Technologies for Health Act of 2021, which builds on prior iterations of the bill with learnings from the COVID-19 pandemic.

To print this article, all you need is to be registered or login on Mondaq.com. The Biden Administration used the annual rulemaking that governs health plans sold on the Affordable Care Acts exchanges to lower health care costs for consumers and improve access to health care. Part 2 of the Notice of Benefit and Payment Parameters for 2022 Final Rule (the Payment Notice), issued April 30, 2021, is the second in a series of rulemakings addressing exchange plans. 1 The Depa...

Friday, April 30, 2021 The Biden Administration used the annual rulemaking that governs health plans sold on the Affordable Care Act’s exchanges to lower health care costs for consumers and improve access to health care. Part 2 of the Notice of Benefit and Payment Parameters for 2022 Final Rule (the Payment Notice), issued April 30, 2021, is the second in a series of rulemakings addressing exchange plans. [1]  The Department of Health and Human Services (HHS) anticipates addition...

[author: Christopher Jew] On April 19, 2021, HHS OIG Principal Deputy Inspector General Christi A. Grimm gave the keynote address at the Health Care Compliance Association’s 25th Annual Compliance Institute wherein she highlighted 10 key compliance priorities that will drive much of OIG’s work in the coming year and beyond. While these priorities do not represent OIG’s full work plan and there are other core areas OIG is focused on, the compliance priorities include: (1) Overseeing COVID-...

To embed, copy and paste the code into your website or blog: In this episode, Husch Blackwell’s Meg Pekarske and Bryan Nowicki discuss the new wave of CMS Center for Program Integrity (CPI) audits that have been issued during the past couple weeks. These CPI audits remain focused on long length of stay patients and typically involve hundreds of claims valued at over $1 million. As Meg and Bryan explain, these audits may signal a new approach to auditing by CMS, and it is important for hospice...

Monday, March 1, 2021 Companies who feel the Public Health Emergency (PHE) waivers and exceptions have rendered telemedicine “immune” from compliance oversight might be surprised to learn what federal regulators have in the works. The Office of Inspector General (OIG) at the Department of Health & Human Services (HHS) is conducting at least seven different national audits, evaluations, and inspections of telemedicine services under the Medicare and Medicaid programs. The audits ...

We continue to follow up on the unemployment fraud impacting people across southern Colorado. The widespread fake claims are impacting people who didn't apply for the benefits and those who are waiting on the crucial benefit dollars to make ends meet during these difficult times.

No Time to Lose: Solutions to Increase COVID-19 Vaccinations in the States The House Committee on Energy and Commerce, Subcommittee on Oversight and Investigations will hold a hearing on COVID-19 vaccine distribution and administration. Find more details here. Wednesday, February 3 Road to Recovery – Ramping Up COVID-19 Vaccines, Testing, and Medical Supply Chain The House Committee on Energy and Commerce, Subcommittee on Health will hold a hearing on the federal government’s handling of CO...

Local Psychologist Sentenced In Medicaid Fraud Scheme Patch 1/28/2021 Michael Seale © Shutterstock A Vestavia Huills psychologist has been sentenced to three years in prison in a medicaid fraud scheme. BIRMINGHAM, AL — A former psychologist who ran a counseling clinic in Vestavia Hills has been sentenced to three years in prison for her role in a scheme that defrauded the Alabama Medicaid Agency of at least $1.5 million. Shannon Waltz, 51, pleaded guilty in 2019 to one co...

Share: Anthem, Inc. (NYSE:ANTM) announced today Dr. Shantanu Agrawal has been named Chief Health Officer, effective January 25, 2020. Dr. Agrawal will oversee Anthems enterprise health strategy, to include medical policy and clinical quality, as well as the companys industry-leading work to address the social drivers of health. He will also lead Anthems community health strategy and the Anthem Foundation. He will report directly to Gail K. Boudreaux, President and Chief Executive Officer, Anthe...