On January 20, 2021, the Biden Administration issued a memorandum to all agencies announcing a regulatory freeze. The memorandum applies to a number of rules, including those rules that.
Biden Administration issued a memorandum to all agencies announcing a regulatory freeze, applying to number of rules, including those rules that have been published in the Federal Register such as the new Stark Law and Anti-Kickback Statute final rules.
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The U.S. Department of Justice announced Monday that four people and one company have recently pleaded guilty in a telemedicine pharmacy healthcare-fraud conspiracy that allegedly lasted for years.
The group was charged with a conspiracy to defraud pharmacy benefit managers out of $174,202,105 by submitting $931,356,936 for fraudulent prescriptions purchased from a telemarketing company. Telemarketing fraud is a major threat to the integrity of government and commercial insurance programs, said Derrick L. Jackson, special agent in charge at the U.S. Department of Health and Human Services Office of Inspector General in Atlanta. After improperly soliciting patient information, these marketing companies obtained approvals through contracted telemedicine prescribers, then sold those costly prescriptions to pharmacies in exchange for kickbacks, Jackson continued.
Friday, January 15, 2021
Tucked away in the recently enacted 5,500+ page Consolidated Appropriations Act of 2021 (the “Act”) are important provisions tightening up the survey and enforcement procedures for Medicare hospice programs. The Act (Pub. L. 116-260) was signed into law on December 27, 2020. Among other things, the Act’s hospice provisions require that the Secretary of Health and Human Services (the “Secretary”), by October 1, 2022, develop intermediate sanctions, including civil monetary penalties, and impose these sanctions on Medicare-certified hospice programs in response to survey deficiencies.
This spotlight on hospice survey enforcement comes as no surprise. For a few years, Congress has considered several bills to put more rigor into the Medicare survey process for hospices, including the Helping Our Senior Population in Comfort Environments Act (“HOSPICE Act”). This legislative effort was fueled by a series of recent reports that
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On Thursday, December 17, 2020, senior representatives of the US Department of Health and Human Services’ Office of Inspector General (“OIG”) and the Centers for Medicare & Medicaid Services (“CMS”) delivered a virtual presentation to American Health Law Association members and other health industry stakeholders to explain and elaborate on significant new regulations that become final on January 19, 2021. OIG Senior Counselor for Policy, Vicki Robinson, OIG Industry Guidance Branch Chief, Susan Edwards, and OIG Senior Counsel, Samantha Flanzer, discussed OIG’s recently issued final rules amending current and adding new safe harbors to the Anti-Kickback Statute (“AKS”). CMS Senior Technical Advisors, Lisa Wilson and Catherine Martin, discussed CMS’s recently issued final rules amending current and adding new exceptions to the Physician Self-Referral Law (“Stark Law”).