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Last month, the Department of Health and Human Services Office of Inspector General (“OIG”) issued a
Special Fraud Alert regarding fraud and abuse concerns related to speaker programs offered by pharmaceutical and medical device companies. Over the last three years, these companies have paid nearly $2 billion to health care providers for these events. Additionally, the Department of Justice in conjunction with the OIG has investigated and resolved numerous cases of alleged violations of the anti-kickback statute in relation to these programs.
The anti-kickback statute prohibits the offer, solicitation, receipt, or payment of remuneration to induce or reward referrals of items and services that are paid by federal health care programs. OIG investigations revealed that health care providers often receive generous compensation to speak at programs that offer minimal educational value to other health care providers. Th
Doctor Sentenced to Prison for Unlawfully Distributing Controlled Substances Details Written by DOJ
Lexington, Kentucky - A Kentucky doctor and his former office manager were sentenced to 60 and 32 months respectively in prison Wednesday for their roles in unlawfully distributing controlled substances during a time when the defendants did not have a legitimate medical practice.
Acting Assistant Attorney General Brian C. Rabbitt of the Justice Department’s Criminal Division, U.S. Attorney Robert M. Duncan Jr. of the Eastern District of Kentucky, Special Agent in Charge Derrick Jackson of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Atlanta Field Office, Special Agent in Charge D. Christopher Evans of the U.S. Drug Enforcement Administration’s (DEA) Detroit Field Division, and Executive Director W. Bryan Hubbard of the Kentucky Medicaid Fraud Control Unit (MFCU) made the announcement.
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In November 2020, the Centers for Medicare & Medicaid Services (CMS) and the Department of Health and Human Services Office of Inspector General (OIG) each issued long-awaited final rules that modernize and change the Stark Law and Anti-Kickback Statute (AKS) regulations, respectively. The final rules are generally effective on January 19, 2021. Although these rules are complex and extensive, they aim to assist providers to transition to value-based care by providing greater flexibility and clarity around participation in value-based and coordinated care arrangements. According to CMS and OIG, the additional flexibility in the Stark Law and the AKS does not diminish the laws’ ability to safeguard against government health care program abuses nor does it diminish CMS’ and OIG’s ability to use its enforcement powers to punish such abuses.
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The U.S. Department of Health and Human Services Office of Inspector General is seeking additional compliance obligations from eClinicalWorks relating to the safety of its electronic health record software.
In a recent letter to eClinicalWorks compliance officer Michael D. Laycob, OIG expressed significant concerns regarding patient safety issues and the company s current compliance with the obligations imposed under a corporate integrity agreement that was enacted following eCW s 2017 False Claims Act settlement.
The new obligations include:
Enhancing patient safety notifications.
Submitting monthly progress reports to OIG, the Office of the National Coordinator for Health IT and the Software Quality Oversight Organization.
Thursday, December 10, 2020
In November 2020, the Centers for Medicare & Medicaid Services (CMS) and the Department of Health and Human Services Office of Inspector General (OIG) each issued long-awaited final rules that modernize and change the Stark Law and Anti-Kickback Statute (AKS) regulations, respectively. The final rules are generally effective on January 19, 2021. Although these rules are complex and extensive, they aim to assist providers to transition to value-based care by providing greater flexibility and clarity around participation in value-based and coordinated care arrangements. According to CMS and OIG, the additional flexibility in the Stark Law and the AKS does not diminish the laws’ ability to safeguard against government health care program abuses nor does it diminish CMS’ and OIG’s ability to use its enforcement powers to punish such abuses.