Archives
- 2013.05.20: Bard Agrees to $48.26 Million Settlement for FCA Violations
- 2013.05.17: Jury Rules Tuomey Violated Stark Law and the FCA through Physician Employment Agreements
- 2013.05.15: Recovery Auditors (RACs) target Hospice Face-to-Face Recertifications
- 2013.05.14: Blue Cross Blue Shield of Michigan Auditing Physicians Performing In-Office Drug Screens
- 2013.05.09: OIG Issues Special Advisory on Exclusion Issues
- 2013.05.08: OIG Release Report Focusing on Hospice's Use of General Inpatient Care
- 2013.05.06: Therapy Providers Face Manual Review of Outpatient Therapy Claims, CMS Releases FAQ
- 2013.05.03: CMS Releases Proposed Rule to Revise Provider Enrollment Provisions and the Incentive Reward Program
- 2013.04.29: CMS Releases Proposed Rule Regarding Hospital Inpatient Admissions
- 2013.04.24: CMS Announces Plans to Introduce a Fifth RAC for DME and HHH
- 2013.04.23: CMS Updates Additional Document Requests Limits for Medicare Providers
- 2013.04.18: OIG Releases Updated Provider Self-Disclosure Protocol
- 2013.04.05: Intermountain Health System Agrees to $25.5 Million Settlement in Stark Violation Case
- 2013.04.02: CMS Holds Open Door Forum to Address Recent Changes to the Medicare Part B Payment Policy Following the Denial of a Part A Inpatient Hospital Claim
- 2013.03.29: CMS to Hold Open Door Forum to Discuss Recent Changes to the Medicare Part B Payment Policy
- 2013.03.29: CMS Releases Change Request 8185 to Implement Recent CMS Ruling.
- 2013.03.27: OCR Issues ICR on HIPAA Audit Program
- 2013.03.22: OMHA Releases Instructions for Submitting Withdrawals of Part A Appeals
- 2013.03.18: MACs to Recover Annual Wellness Visit Overpayments
- 2013.03.15: CMS Announces Revised Policy on Part B Billing Following the Denial of a Part A Inpatient Hospital Claim
- 2013.03.14: The United States Senate Committee on Finance Released a Comprehensive Report to Combat Waste, Fraud, and Abuse in Medicare and Medicaid
- 2013.03.06: DOJ and HHS Report Record Recoveries from Healthcare Fraud
- 2013.02.22: Senate Bill Aims to Close Observation Stay Loophole
- 2013.02.19: Andrew Wachler to Present at RAC University's Live Webcast on February 21, 2013
- 2013.02.06: Wachler & Associates Partner is quoted in Home Health Line Article
- 2013.02.05: CMS Releases Proposed Rule Providing an Exemption to Group Health Plan Contraceptive Coverage for Eligible Religious Organizations
- 2013.01.18: Department of Health and Human Services Issues Letter to Providers on Disclosures to Avert Threats to Health or Safety
- 2013.01.14: Fiscal-Cliff Agreement Gives Medicare Officials Five Years to Collect Overpayments
- 2012.12.07: RACs Correct $2.4 Billion in Improper Payments in FY 2012
- 2012.12.04: New Home Health Issues Added to CMS-Approved Issues List for RAC Region B
- 2012.11.26: CMS Releases Final Rule for New Survey and Sanction Options for Home Health Agencies
- 2012.11.26: CMS Reminds Providers to Prepare and Maintain Legible Medical Records
- 2012.11.16: OIG Releases Report Addressing Improvements Needed at the ALJ Appeal Level
- 2012.11.13: CMS Releases DME Face-to-Face Encounter Final Rule
- 2012.11.02: AHA Files Lawsuit Against HHS Regarding Full Part B Reimbursement
- 2012.10.31: Proposed Settlement Agreement Filed in Federal Court Which Could Change SNF and Home Health Coverage
- 2012.10.30: AHA Sends Letter to OIG Urging Contractor Reform
- 2012.10.25: Medicare Audit Improvement Act of 2012 Proposes to More Heavily Regulate Audit Contractors
- 2012.10.17: HDI Posts First Pre-Payment Review Issue
- 2012.10.15: OIG Work Plan Looks at Physician-Owned Distributorships
- 2012.10.11: OIG 2013 Work Plan Includes Reviews of DME Suppliers
- 2012.10.10: OIG Work Plan Includes Review of Hospitals
- 2012.10.09: OIG 2013 Work Plan Includes Reviews of Long-Term Care Providers
- 2012.10.08: OIG 2013 Work Plan Includes Review of Ambulance Suppliers
- 2012.10.02: OIG Report Finds Medicare Paid $24.6 Million for Illegal Prescription Refills
- 2012.10.01: Federal Government Warns Hospitals on Fraudulent EHR Use
- 2012.09.28: HHS Office of Civil Rights Secures $1.5 million HIPAA Settlement
- 2012.09.25: OMB Issues Report to Congress Warning of $11.1 Billion Medicare Cut
- 2012.09.24: CMS to Conduct Special Open Door Forum on Medicare's Prior Authorization for Power Mobility Devices Demonstration
- 2012.09.20: Ninth Circuit Decides RAC Reopening is Not Subject to Appeal
- 2012.09.20: OIG Report Finds Overpayments to Inpatient Rehab Facilities
- 2012.09.18: Name Change for Region A RAC
- 2012.09.14: CMS Releases Follow-Up Comparative Billing Reports for Podiatry Services
- 2012.09.14: OIG Issues Unfavorable Advisory Opinion Regarding an Ambulance Supplier's Proposal to Waive Cost-Sharing Amounts for Part-Time Emergency Medical Services
- 2012.09.13: Comparative Billing Reports Sent to Skilled Nursing Facilities
- 2012.09.06: AHA Survey Shows RAC Denials Up in 2nd Quarter
- 2012.09.04: DOJ Contacts Hospitals About Improperly Billed Heart Implants
- 2012.08.31: Congressman Urges Investigation Into Connolly
- 2012.08.31: Ohio Providers May Be Subject to Double Audit Under Demonstration Program
- 2012.08.31: CMS Begins Prepayment Review Demonstration Program
- 2012.08.13: OIG Report Finds Overpayments for Cancer Drug Herceptin
- 2012.08.10: CMS to Release Comparative Billing Reports for SNF Billing Practices
- 2012.08.08: Breakthrough in the Effort to Obtain Full Part B Reimbursement for Hospitals with Inpatient Claims Denied for Medical Necessity
- 2012.08.07: CMS Begins Meaningful Use Audits
- 2012.08.06: OIG Issues Report on Questionable Billing by Home Health Agencies
- 2012.08.06: CMS to Hold Special Open Door Forum on RAC Audit Prepayment Review Program
- 2012.08.06: CMS Releases Provider Compliance Interactive Map
- 2012.08.03: CMS Considers Changing its Policy Regarding the Services That can be Rebilled to Medicare Part B
- 2012.07.20: Massive Prescription Drug Scheme Uncovered
- 2012.07.20: CMS Issues Proposed Rule That Would Change Home Health Face-to-face Requirements
- 2012.07.13: Recent RAC Activity
- 2012.07.10: OIG Issues Report on Duplicate Payments for Hospice Medications
- 2012.07.10: CMS Proposes to Add More Face-to-Face Requirements as a Condition of Payment
- 2012.07.03: CMS Accepting ACO Advance Payment Model Applications
- 2012.06.29: Congressional Committee Requests GAO Study of CMS Contractor Redundancies
- 2012.06.22: Medicare Fraud Task Force Targets Psychotherapy Providers
- 2012.06.19: OIG Testimony Before Congressional Subcommittee Outlines Inadequacies of Medicaid Integrity Programs
- 2012.06.14: CMS Extends Notice of Intent to Apply Deadline for ACO Participation in the Shared Savings Program
- 2012.06.12: CMS Releases RAC Data: More Than 43% of Overpayment Appeals Returned in Favor of Providers
- 2012.06.11: Congressional Subcommittee Hears OIG Testimony on Medicare Benefit Integrity Contractors
- 2012.06.11: Federal District Court Overturns Part B Claim on Judicial Review
- 2012.06.08: HHS Releases Memo to Consumers Highlighting HIPAA Rights to Access Health Records
- 2012.06.05: State AG HIPAA Training Materials Available Online
- 2012.06.01: CMS to Release Comparative Billing Reports for Home Oxygen Services
- 2012.06.01: Recent RAC Activity
- 2012.05.31: CMS to Release Comparative Billing Reports for Evaluation and Management Services
- 2012.05.29: Knowledge of Illegality Not Required For Criminal Charges Under HIPAA
- 2012.05.14: CMS Provides List of Providers Who Need to Revalidate Their Medicare Enrollment
- 2012.05.08: CMS Delays Implementation of Physician Payments Sunshine Act
- 2012.04.30: CMS Publishes Final Rule With New Provider and Supplier Requirements
- 2012.04.30: GAO Report Examines CMS Efforts to Strengthen Screening
- 2012.04.17: Various Health Care Organizations Comment on CMS' New Demonstration Programs
- 2012.04.13: OIG Releases Its Updated List of Excluded Individuals and Entities
- 2012.04.10: HHS Announces Proposed Rule to Simpify the Administrative Process for Health Care Providers
- 2012.04.06: Recent RAC Activity
- 2012.04.05: CMS to Release Comparative Billing Reports for Cardiology Services
- 2012.03.23: CMS Releases ACO Eligibility Memo
- 2012.03.20: CMS Adopts Final Rule for DMEPOS Standards
- 2012.03.16: HHS Settles First Breach Notification Case
- 2012.03.06: CMS Proposes Regulations to Implement the Law Regarding Reporting and Returning Overpayments
- 2012.03.06: CMS Provides List of Providers Sent Notices to Revalidate Their Medicare Enrollment
- 2012.02.28: CMS Releases FY2012 RAC Report
- 2012.02.28: OIG Releases Review MIC Report
- 2012.02.27: Recent RAC Activity
- 2012.02.27: Zone Program Integrity Contractor (ZPIC) Audits
- 2012.02.14: Recent RAC Activity
- 2012.02.14: RAC Posts First Home Health Issue
- 2012.02.09: CMS Posts Self-Referral Disclosure Protocol Settlements on Its Website
- 2012.02.09: Medical Billing Professional Sentenced to Prison for Defrauding Medicare and Medicaid
- 2012.02.06: CMS Announces New Start Date for Prior Authorization of PMDs and Recovery Audit Prepayment Review Demonstration Programs
- 2012.01.30: CMS' Q4 Audit Program Activity: $353.7 Million in Improper Payments, Increased Focus on Medical Necessity Claims
- 2012.01.27: CMS Clarifies Procedure for MAC Claims Against DMEPOS Suppliers' Surety Bonds
- 2012.01.25: CMS Publishes Important Reminder to Providers and Suppliers Regarding Referred or Ordered Services and Items
- 2012.01.23: RACs Target Skilled Nursing Facilities with High Therapy Resource Utilization Groups
- 2012.01.19: CMS Clarification of 3-Day Payment Window when Inpatient Admission is Denied
- 2012.01.17: Recent RAC Activity
- 2012.01.13: CNN Quotes Managing Partner Andrew Wachler on ABIM Allegations
- 2012.01.05: CMS Announces Interim Final Rule Creating New Standards for EFTs
- 2012.01.03: CMS has Delayed the Recovery Auditor Pre-Payment Review Demonstration Program
- 2011.12.30: CMS Announces Delay of Power Mobility Device Demonstration Program
- 2011.12.29: CMS Implements 3-day Payment Window Policy for Wholly Owned or Wholly Operated Physician Practices
- 2011.12.23: Ten Highlights from the Proposed Physician Payment Sunshine Act Rule
- 2011.12.22: CMS' Special Open Door Forum on Recovery Auditor Pre-Payment Review Demonstration Program
- 2011.12.20: CMS to Reopen Home Health Claims Denied Based on Face-to-Face Requirements
- 2011.12.19: CMS Announces Special Open Door Forum for the Recovery Auditor Pre-Payment Review Demonstration Program
- 2011.12.05: CMS AB Demonstration Program: Hospitals' Participation in December 8 Open Door Forum
- 2011.11.30: Open Door Forum for Part A to Part B Rebilling Demonstration Program
- 2011.11.30: CMS Releases Last Quarter's Data on Medicare RAC Collections
- 2011.11.29: CMS Releases Part A to B Rebilling Demonstration Program Enrollment Application
- 2011.11.22: OIG Releases Report Highlighting ZPIC Oversight Issues
- 2011.11.22: CMS to Release Comparative Billing Reports for Nerve Conduction Studies
- 2011.11.21: CMS Announces Special Open Door Forum for Part A to Part B Rebilling Demonstration Program
- 2011.11.17: HHS' OCR Set to Begin HIPAA Audit Pilot Program
- 2011.11.17: CMS Announces RAC Pre-Payment Review Demonstration Program
- 2011.11.16: CMS Announces Part A to Part B Rebilling Demonstration Program
- 2011.11.10: Recent RAC Activity
- 2011.11.08: Physician Payment Sunshine Act Rules Delayed
- 2011.10.26: Recent RAC Updates
- 2011.10.26: CMS Announces the Creation of Its Advance Payment Model
- 2011.10.24: 20 Notable Aspects of the Final ACO Rule
- 2011.10.20: CMS Releases Final Rule for Accountable Care Organizations
- 2011.10.20: OIG Releases Unfavorable Advisory Opinion Regarding an Arrangement Between a Physician-Invested Entity and a Pathology Laboratory
- 2011.10.19: US District Court Denies an Ambulance Services' Request for Preliminary Injunction Against a Medicare PSC
- 2011.10.14: CMS Sends ACO Final Rule to the Office of Management and Budget for Review
- 2011.10.14: OIG Releases Fiscal Year 2012 Work Plan
- 2011.10.12: Recent RAC Updates
- 2011.10.12: Recent RAC Updates
- 2011.10.11: Senate Finance Committee Publishes Report About Home Health Agencies
- 2011.10.06: Andrew Wachler Quoted in the American Medical News Regarding National Practitioner Data Bank's Move to Shut Down Public Access
- 2011.09.29: OIG Releases Favorable Advisory Opinion Regarding an Exclusivity Agreement Between a Nonprofit Corporation and Community Hospitals
- 2011.09.29: CMS Releases MLN Matters Article to Assist Chiropractors in Understanding Medicare Coverage Policies
- 2011.09.27: DMEPOS Competitive Bidding Round 2 Update
- 2011.09.22: CMS to Release Comparative Billing Reports for Chiropractors Who Practice in the Office Setting
- 2011.09.21: President Obama Plans to Reform Medicare and Medicaid to Further Aid the Deficit Reduction
- 2011.09.16: OIG Responds to the Senate Finance Committee's Concerns Over PODs
- 2011.09.15: CMS Releases Its Final Rule Implementing the Medicaid RAC Program
- 2011.09.15: CMS Releases a New RAC Statement of Work
- 2011.09.12: Medicare Strike Force Operation Results in Largest Fraudulent Medicare Billing Takedown in Strike Force History
- 2011.09.08: OIG Finds IDTFs Did Not Comply With Medicare Standards During Unannounced Site Visits
- 2011.09.02: Medicare Fraud Indictments in Detroit
- 2011.09.01: CMS Introduces Its esMD Pilot Enabling Providers to Electronically Submit Requested Documentation to Review Contractors
- 2011.09.01: Recent RAC Updates
- 2011.08.25: CMS to Release Comparative Billing Reports for Providers Ordering DME
- 2011.08.24: HHS Introduces the Bundled Payments Initiative to Help Providers Coordinate Patient Care
- 2011.08.24: Recent RAC Updates
- 2011.08.22: New Bill Introduced to Grant Physicians Greater Due Process Rights in Peer Review
- 2011.08.17: OIG Issues Unfavorable Advisory Opinion Regarding an Exclusive Provider Arrangement Between Medical Equipment Supplier and SNF
- 2011.08.16: Affordable Care Act Requires Medicare Providers to Revalidate Their Enrollment By March 2013
- 2011.08.15: Recent RAC Updates
- 2011.08.11: CMS to Release Comparative Billing Reports for Outpatient Physical Therapy Services with the KX Modifer
- 2011.08.10: HHS Estimates $48 Billion of Improper Payments Were Paid to Healthcare Providers in 2010
- 2011.08.09: OIG Issues Favorable Advisory Opinion Regarding a Pay-for-Performance Compensation Plan
- 2011.08.08: MACs Now Responsible for Issuing Medicare Audit Overpayment Demand Letters
- 2011.08.03: Michigan Pharmacists and Doctors Indicted for Fraudulently Billing Millions of Dollars to Medicare
- 2011.08.03: ASC Pay-for-Performance Program Coming Soon
- 2011.08.02: OIG Issues Favorable Opinion Regarding the Use of a Preferred Hospital Network as Part of Medicare Supplemental Health Insurance Policies
- 2011.08.02: CMS Announces Intentions of Reducing Medicare Payments for Hospice Patients Residing in Nursing Facilities
- 2011.07.28: FDA Proposes First Regulations on the Health-Related Mobile Application Industry
- 2011.07.21: Proposed Rule Requires Face-to-Face Encounter for Medicaid Home Health Beneficiaries
- 2011.07.20: Patient Sues Tufts Medical Center for Violating Her Privacy Rights
- 2011.07.19: Detroit Clinic Owner Sentenced to 27 Months in Prison for Medicare Fraud
- 2011.07.19: CMS Releases 3rd Quarter Summary of Medicare FSS RAC Recoveries
- 2011.07.18: HHS Suspects Nursing Homes may be Committing Medicare Fraud
- 2011.07.18: GAO Report Finds CMS' Systems to Detect Fraud 'Inadequate and 'Underused'
- 2011.07.14: CMS to Release Comparative Billing Reports for Physicians Ordering Spinal Orthotic Devices
- 2011.07.13: OIG Concerned About the Rising Costs of Hospice Care
- 2011.07.12: Recently Released Medical Marijuana Memo Contradicts Obama Administration's Policy Not to Interfere with State Law
- 2011.07.12: The University of California at Los Angeles Health System Agrees to Settle After Violating HIPAA
- 2011.07.11: Recent RAC Updates
- 2011.07.11: CMS Releases Article Discussing DRG Coding Vulnerabilities for Inpatient Hospitals
- 2011.07.07: CMS Proposes to Rescind the Signature Requirement for Lab Requisitions Required under the 2011 Medicare Physician Fee Schedule
- 2011.07.06: DRG Coding Vulnerabilities in the Recovery Audit Program
- 2011.06.30: OIG Issues Unfavorable Opinion Involving an Incentive Arrangement Between a DME Supplier and Several IDTFs
- 2011.06.30: Obama Administration Opts to Abandon Its Recently Announced "Mystery Shopper" Survey
- 2011.06.29: CMS Advisory Opinion Finds Non-Compete Provision Meets the Requirements of Stark Law Physician Recruitment Exception
- 2011.06.28: Obama Administration Implements "Mystery Shopper" Initiative to Address the Increasing Shortage of Primary Care Doctors
- 2011.06.27: Senate Report Probes PODs
- 2011.06.23: Comparative Billing Reports and the Risk of a Future Audit
- 2011.06.22: HITPC Recommended to Push Back Stage 2 Meaningful Use Requirement Deadline
- 2011.06.22: Wachler & Associates Attorney Participated on ABA's ACO Task Force
- 2011.06.20: DCS Healthcare Announced 11 New Issues for Medical Necessity Review
- 2011.06.16: Pioneer ACO Model Program Participation Deadline Extended
- 2011.06.15: OIG Issues Favorable Opinion Regarding a Vaccine Reminder Program
- 2011.06.13: New Rule in Effect for Provider Enrollment Process
- 2011.06.13: ONC Announces New Initiative to Promote Health Information Technology
- 2011.06.09: AARP Tool Implemented to Fight Medicare Fraud
- 2011.06.08: OIG Reports Providers Charged Medicare for Nonmedical Services
- 2011.06.07: CMS Proposed Rule Regarding E-prescribing Requirements for Physicians
- 2011.06.06: Sleep Medicine Company Agrees to $650,000 Settlement
- 2011.06.03: OIG Announces $3.4 Billion in Semiannual Recovery
- 2011.06.03: RAC Program Expands to Medicare Part D in Third Quarter of 2011
- 2011.06.02: Healthcare Providers Receive $158 Million in EHR Incentives from U.S. Government
- 2011.06.02: Pioneer ACO Model Program Participation Deadline
- 2011.06.01: OIG Issues Favorable Opinion Regarding Shared Services of an Air Force Medical Group and Community Hospital
- 2011.06.01: HHS Announces Proposed Changes to HIPAA Privacy Rule
- 2011.05.31: Company Agrees to Settle Medicare Fraud Claim for $650,000
- 2011.05.27: Recent ACO Updates
- 2011.05.27: Recent RAC Updates
- 2011.05.26: OIG Reports that CMS has made Duplicate Payments to Home Health Services
- 2011.05.26: Bill Passed Limiting Medical Malpractice Liability
- 2011.05.25: All Four RAC Regions Have Recently Added Additional Issues Approved for Review in RAC Audits
- 2011.05.25: CMS Issues Relaxed Telemedicine Rules
- 2011.05.24: Survey Highlights Key Problems for EHR Switch
- 2011.05.24: EHR Incentive Payments Begin This Week
- 2011.05.23: OIG Issues Unfavorable Opinion on Proposed Joint Venture
- 2011.05.23: Physicians Using EHRs Increased by 9%
- 2011.05.17: Physician Convicted of Medicare Fraud for Violating the Anti-Kickback Statute
- 2011.05.17: 32 Employees Dismissed for Violating HIPAA
- 2011.05.17: RAC Recovered $237.8 Million in Six-Month Period
- 2011.05.17: U.S. Attorneys Warn States About Potential Prosecution for Medical Marijuana Use
- 2011.05.16: Face to Face Checklist for Power Wheelchairs
- 2011.04.15: Attestations To Meaningful Use Requirements Begin April 18
- 2011.04.15: Phase 2 of DME Competitive Bidding Process Expected In Spring of 2011
- 2011.04.13: Ambulatory-care Physicians Satisfied with EHR Systems
- 2011.04.08: Update: Face-to-Face Requirments Effective April 1, 2011
- 2011.04.08: Highlights from CMS Telephone Conference on Accountable Care Organizations
- 2011.04.08: Proposed Rule Relaxes DMEPOS Supplier Restrictions
- 2011.04.06: 30 Highlights from the ACO Proposed Rule
- 2011.04.01: Proposed Law Would Protect Michigan Hospitals That Apologize To Patients For Mistakes
- 2011.03.30: The Regulations are coming! Ten things that we already know about Accountable Care Organizations.
- 2011.03.30: Groups Seek Additional Delay In Face-to-Face Encounter Requirement
- 2011.03.16: Proposed Bill Seeks to Strengthen Health Care Enforcement Tools
- 2011.03.11: State Attorney Generals Have Workshops in HIPAA Enforcement
- 2011.03.09: GAO Report Discovers Waste in Government Programs
- 2011.03.04: Justice Department Seeks Clarification on Health Care Reform Suit Ruling
- 2011.03.02: Recent RAC Activity
- 2011.02.25: CMS Announces New Limits on RAC Record Requests
- 2011.02.18: Medicare Strike Force Continues Aggressive Investigations of Health Care Providers, Makes 111 Arrests
- 2011.02.11: New Issues Posted by RACs
- 2011.02.04: E-Prescribing Program Offers Participating Physicians Incentives
- 2011.01.28: OIG Issues Favorable Opinion Regarding Waivers of Co-Payments and Other Cost Sharing Amounts By a Charity Hospital
- 2011.01.26: CVS Pays for Improper Billing
- 2011.01.21: Moratorium on Enforcement of the Face-to-Face Encounter Requirement of Home Health and Hospice Services
- 2011.01.19: ONC Released Final Rule on Electronic Health Record Certification
- 2011.01.18: DAB Adds Clarity to What Constitutes a Mobile Independent Diagnostic Testing Facility
- 2011.01.14: Increased Spending by the Obama Administration to Fight Fraud
- 2011.01.06: Federal Government Increases Fight against Medicare Fraud
- 2011.01.05: Andrew Wachler quoted in the Detroit Free Press regarding DMC's Settlement with the Federal Government
- 2011.01.04: The OIG Publishes an Unfavorable Advisory Opinion on a Proposal to Offer Transportation Services to Skilled Nursing Facilities
- 2011.01.04: DMC to Pay a $30 Million Settlement to the Federal Government
- 2010.12.23: OIG Reports a $25.9 billion Expected Recovery of Savings in FY 2010
- 2010.12.20: Medicare Physician Rate Cut Delayed for One Year
- 2010.12.16: Federal District Court Holds That the Individual Mandate in PPACA is Unconstitutional
- 2010.12.13: The Red Flag Program Clarification Act of 2010 Passes in the House and Senate
- 2010.12.03: The Justice Department Announces $3 Billion Recovery from Pursuing False Claims Against the Federal Government
- 2010.11.22: Proposed Purchase Of DMC Has Been Conditionally Approved
- 2010.11.18: Health care summit series continues in Brooklyn, New York
- 2010.11.12: The United States Supreme Court Refuses to Hear Challenge to the Healthcare Reform Law
- 2010.11.10: Device Manufacturer Settles False Claims Qui Tam Action
- 2010.11.08: CMS Publishes Proposed Rule Regarding Medicaid RAC Activities
- 2010.11.04: Pacemaker and Defilbrillator Implantations Make Prime RAC Targets
- 2010.11.01: The U.S. Justice Department Files Lawsuit Against Blue Cross Blue Shield of Michigan
- 2010.10.27: Joint Commission Announces Accreditation Standards for Patient-Centered Medical Homes
- 2010.10.25: OIG Releases Work Plan For Fiscal Year 2011
- 2010.10.25: Most Recent RAC Activity
- 2010.10.20: CMS Releases Letter to State Medicaid Directors Regarding Medicaid RACs
- 2010.10.18: OIG Advisory Opinion 10-20 and 10-21
- 2010.10.13: U.S. District Judge Refuses to Grant Injunction Against Health Care Reforms Implemented through the Affordable Care Act
- 2010.10.08: American Hospital Association Releases RACTrac Survey
- 2010.10.07: OIG Advisory Opinion 10-17
- 2010.10.06: The OIG Publishes Two Favorable Advisory Opinions
- 2010.09.30: CMS Begins Preparing for RAC Expansion to Medicaid
- 2010.09.29:
- 2010.09.23: RAC for Region A Adds New Issues for Medical Necessity Review
- 2010.09.23: CMS Publishes Proposed Rule Implementing Affordable Care Act Provisions
- 2010.09.22: The OIG Publishes an Unfavorable Advisory Opinion Involving a Manufacturer's Proposal to Compensate Providers for Warranty-Covered Services
- 2010.09.20: U.S. District Judge Likely to Allow Lawsuit Challenging Healthcare Reform to Proceed
- 2010.09.17: Concierge Medical Practices on the Rise
- 2010.09.15: CMS Publishes a New Rule Affecting DME Providers
- 2010.09.10: The DMC Announces Cost-Savings From the Use of Electronic Medical Records
- 2010.09.08: The OIG Publishes Two Advisory Opinions
- 2010.09.02: The ONC Names Technology Review Bodies to Certify EHR Systems
- 2010.09.01: RACs for Regions D and C Add Medical Necessity Reviews to Approved Issues Lists
- 2010.08.26: Michigan Selects Insurer for High Risk Insurance Pool
- 2010.08.24: Michigan Doctor Sentenced to Prison for Medicare Fraud
- 2010.08.23: The OIG Publishes Reports Targeting IRFs
- 2010.08.19: Michigan Receives $1 Million of Grants to Improve Oversight of Health Insurance Premium Increases
- 2010.08.18: OIG Publishes Report Showing Overpayments to DME Suppliers
- 2010.08.17: OIG Report Identifies Overpayments to Physicians for Incorrect Place of Service Codes
- 2010.08.16: CMS Reminds Providers of the Document Retention Requirements
- 2010.08.13: RACs Will Begin Medical Necessity Reviews
- 2010.08.12: OIG LEIE Search Errors
- 2010.08.11: Michigan Attorney General Mike Cox Will Host a Forum on DMC-Vanguard Deal
- 2010.08.11: The OIG Releases an Advisory Opinion Regarding the Anti-Kickback Statute
- 2010.08.10: District Court Ruling - Medicare Contractors Can Reopen Claims Regardless of "Good Cause"
- 2010.08.03: HHS Announces Grants to Help States Implement Health Insurance Exchanges
- 2010.07.08: Michigan Group's Effort to Push Back Healthcare Reform Falls Short
- 2010.07.07: The Department of Health and Human Services Opens Notice and Comment Period for New HIPAA Privacy Rule
- 2010.07.06: Michigan's Medicaid Funding at Risk
- 2010.07.05: Update on ABIM Recommended Suspensions
- 2010.07.01: The OIG's Report on Inpatient Rehabilitation Facility Claims Could Lead to RAC Reviews
- 2010.06.28: Codification of the Hospital 3-Day Payment Window
- 2010.06.27: RACs Post New Issues
- 2010.06.24: CMS Reports that Providers Are Winning a Large Percentage of Appeals
- 2010.06.23: The OIG Releases an Advisory Opinion Regarding the Dietitian and Social Worker Services Provided at a Freestanding Radiation Oncology Center
- 2010.06.22: The Senate Passes a Plan to Fix Medicare Physician Payment for Another Six Months
- 2010.06.21: Federal Wrangling May Negatively Impact Michigan's Medicaid Program
- 2010.06.20: Michigan's Uninsured Chronically Ill May Have New Coverage Option
- 2010.06.17: Update on ABIM Suspensions**
- 2010.06.17: Government Accountability Office (GAO) Recommends Post-Payment Reviews to Focus on Home Health and Durable Medical Equipment
- 2010.06.14: Accountable Care Organizations Grow in Michigan
- 2010.06.10: The American Board of Internal Medicine Takes Formal Action Against Physicians**
- 2010.06.09: The RAC for Region D Adds New Issues
- 2010.06.08: St. Jude Medical Center to Pay $3.7 Million Kickback Settlement
- 2010.06.03: The OIG Releases Two Advisory Opinions
- 2010.05.31: BCBSM Will Cease Payment on CPT Consultation Codes for Medicare Plus Blue PFFS and Medicare Plus Blue PPO
- 2010.05.31: Sale of DMC to Vanguard Health Systems is Delayed
- 2010.05.31: RACs Post New Issues for All Four Regions
- 2010.05.25: Motion to Dismiss Virginia Attorney General's Healthcare Reform Challenge
- 2010.05.24: Health Alliance of Greater Cincinnati Settles False Claims Suit
- 2010.05.23: CMS Releases MLN Matters Article Explaining Additions to the Medicare Program Integrity Manual
- 2010.05.16: MLN Matters Article Discusses New Remittance Advice Code Created to Identify Claims Subject to the Limitation on Home Health Prospective Payment System Outlier Payments
- 2010.05.16: CMS Clarifies Signature Requirements
- 2010.05.16: U.S. Western District Court of Michigan Dismisses False Claims Act Claim for Failure to State a Claim with the Required Particularity
- 2010.05.16: PPACA Grants Authority to the Secretary of the Department of Health & Human Services to Require Health Care Providers to Adopt Compliance Programs
- 2010.05.11: CMS Issues New Transmittal to Address Concerns with Recoupments
- 2010.05.11: Request for Information on the Expansion of the Right to Receive an Accounting of Disclosures
- 2010.05.11: Surgeon Sentenced to Prison for HIPAA Violation
- 2010.05.11: Requirements for the Home Health Care CAHPS Survey
- 2010.04.30: The RAC for Region C Adds New Issues
- 2010.04.26: Healthcare Reform Legislation Changes Medicare Timely Filing Requirements
- 2010.04.25: Professional Medical Organizations Adopt New Ethics Codes
- 2010.04.20: Proposed Bipartisan Bill Extends Electronic Health Records Incentives to Mental Health Professionals
- 2010.04.20: Medicare Physician Rate Cut Delayed until May 31, 2010
- 2010.04.14: Healthcare Reform Results in Amendments to the Anti-Kickback Statute
- 2010.04.14: Healthcare Reform Adds Reporting Requirements for Vendor-Provider Relationships
- 2010.04.14: Changes in CLIA Requirement for Processing Personnel
- 2010.04.14: Proposed House Bill Would Increase Penalties for Medicare Fraud
- 2010.04.14: Check the RAC!
- 2010.04.14: Healthcare Reform's Changes to Home Health Certification and DME Certification
- 2010.04.11: The Healthcare Reform Bill Amends Civil Monetary Penalties Law
- 2010.04.06: Andrew Wachler participates as a guest speaker at the RAC Monitor Webinar
- 2010.04.06: Andrew Wachler presented "The New Audit Landscape: MICs, MACs, and RACs" for an American Bar Association (ABA) teleconference
- 2010.03.31: Recovery Audit Contractors (RACs) for three Regions post new issues for non-medical necessity DRG validation inpatient claims reviews
- 2010.03.31: Medicare Appeals Council requires RACs to use covered Medicare Part B services to off-set a Medicare Part A overpayment
- 2010.03.28: The Patient Protection and Affordable Act of 2009 strengthens the False Claims Act (FCA)
- 2010.03.28: Healthcare Reform Bill to Enhance Pain Management Treatment
- 2010.03.24: Rush University Medical Center Agrees to $1.5 Million Settlement to Resolve Alleged FCA Violations
- 2010.03.24: Florida Legislation to Increase Medicaid Antifraud Efforts
- 2010.03.24: The Department of Health and Human Services Invests More Funds to Advance the Meaningful Use of Health IT
- 2010.03.24: The American Hospital Association Submits Comments to CMS on Proposed EHR Meaningful Use Rule
- 2010.03.24: Fewer Doctors Accepting Medicaid
- 2010.03.24: Michigan Receives Health Information Technology Grant
- 2010.03.24: Expansion of the RAC Program
- 2010.03.10: Michigan Providers Must Charge Patients Less for Copies of Medical Records
- 2010.03.10: The Department of Health and Human Services Releases a Notice of Proposed Rulemaking for the Establishment of Certification Programs for Health Information Technology (Health IT)
- 2010.03.08: National Practitioner Data Bank Expanded
- 2010.03.08: Medicare Physician Payment Cuts - Ten More Days
- 2010.03.02: Expansion of Michigan's Chiropractic Scope of Practice
- 2010.03.02: Michigan's Governor Establishes Health Inspector General
- 2010.03.02: First State Attorney General to Take Action against Covered Entity Responsible for Massive HIPAA Violations
- 2010.02.21: RACs Reporting Potential Cases of Fraud
- 2010.02.21: Preventing the 21 percent cut in Medicare payments - Hurdles to Overcome in the Senate
- 2010.02.21: Home Health Providers See Changes to Payments in 2010
- 2010.02.09: CMS Rescinds Change Request 6375
- 2010.02.07: CMS Announces Modified Additional Documentation Request Limits for Institutional Providers
- 2010.02.03: Health Professionals Petition the FTC for Relief from Red Flags Rule
- 2010.02.03: Region D RAC Approves Anesthesia Services for Review
- 2010.01.26: U.S District Court Dismisses Lawsuit Regarding Physician Payment Cuts to Medicare Reimbursements
- 2010.01.23: OIG Fraud Alert to DME Suppliers on Telemarketing Prohibition
