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HHS OIG Reviews FY 2010 Recoveries by State MFCUs

October 17, 2011 | Blog | By Brian Dunphy

Last week, the OIG released an interesting interactive chart listing, by state, key statistics of state Medicaid Fraud Control Units (MFCU) for FY 2010. The statistics, while perhaps an imperfect comparison among the MFCUs, provide insight into the level of activity in each state, the total amount recovered by each MFCU, and the resources allocated to combat Medicaid fraud, waste, and abuse in each state.
In an Advisory Opinion long awaited by many in laboratory industry, the OIG concluded that a proposed arrangement that would have allowed physicians to profit from their own referrals for anatomic pathology services would “pose more than a minimal risk of fraud and abuse.” 

Manufacturers Still in the Dark About the Sunshine Act

October 11, 2011 | Blog | By Brian Dunphy

Manufacturers of pharmaceuticals, devices, and biological or medical supplies are well aware of an impending January 1, 2012 deadline to start collecting information for reports mandated by the federal “Physician Payments Sunshine Act,” which was part of health care reform legislation.
ML Strategies has posted its weekly Health Care Reform Update providing timely information on implementation of the Affordable Care Act and other state and federal administrative and legislative activities related to health care reform.

OIG Is Watching: FY12 Work Plan Focuses on Data Mining

October 10, 2011 | Blog | By Brian Dunphy

The Office of Inspector General released its Work Plan for Fiscal Year 2012 describing the focus of its activity for the next fiscal year. 
The Supreme Court has just heard oral argument in a case that raises the issue of whether Medicaid providers and recipients can challenge state decisions to cut Medicaid rates.
Emboldened by significant electoral gains in the 2010 midterm elections, Republican lawmakers have devoted significant time and attention to repealing “Obamacare.” 

HIPAA Isn't the Only Data Breach Law of Concern

October 6, 2011 | Blog | By Karen Lovitch, Dianne Bourque

In the event of a data breach, covered entities must consider state law notification requirements, as well as those imposed by HIPAA. Toward that end, Mintz Levin has developed a survey of state data breach notification laws, which is a useful tool for understanding the types of protections states require, breach notification triggers, timing, and other specifics.

When Is It Time to Pull the Plug in a Health Care Transaction?

October 6, 2011 | Blog | By Karen Lovitch

The Deal Pipeline recently published my article entitled Pulling the Plug?, which discusses the important question that many buyers must face in health care transactions: when is it time to walk away from the potential acquisition of a health care company that is under government investigation? 
ML Strategies has posted its weekly Health Care Reform Update providing timely information on implementation of the Affordable Care Act and other state and federal administrative and legislative activities related to health care reform.

Wisconsin Medicare Part C FCA Settlement for Business Misconduct

October 4, 2011 | Blog | By Ellyn Sternfield

In a  Medicare Part C (or “Medicare Advantage”) False Claims Act settlement announced by the Milwaukee-Wisconsin Journal-Sentinel on September 25th, an operator of a Germantown Wisconsin Medicare Advantage plan and its parent agreed to pay $4.8 million to settle allegations that the company improperly paid eligible individuals to enroll in the Medicare Advantage plans, then misled them about the scope of coverage. 
The split among the federal circuit courts over the “implied certification” of liability under the federal False Claims Act (FCA) is figuratively banging at the Supreme Court’s door.
House Subcommittee Chairman Rehberg (R-MT) unveiled his draft Labor, Health and Human Services, and Education appropriations bill that would cut $2.4 billion from 2011 funding levels, on Thursday.
ML Strategies has posted its weekly Health Care Reform Update providing timely information on implementation of the Affordable Care Act and other state and federal administrative and legislative activities related to health care reform.
In the kickoff to this year’s fall conference season, Mintz Levin’s own Thomas S. Crane will be speaking about the Anti-Kickback Statute (AKS) and current developments on Monday, September 26th at the American Health Lawyers Association (AHLA) Fraud and Compliance Forum.

OIG "tweets" fraud and abuse educational materials for physicians

September 21, 2011 | Blog | By Brian Dunphy

On September 18, the Office of Inspector General (OIG) for the Department of Health & Human Services “tweeted” about its Physician Education Training Materials, which are designed to teach physicians how to comply with the Federal fraud and abuse laws.  OIG has increasingly used Twitter to publish information that may be of interest to providers.

Texas Health Care Privacy Law

September 20, 2011 | Blog | By Daria Niewenhous

In this article "Texas Law Gives Privacy More Muscle than HIPAA", published by Law360 on September 16, 2011, Mintz Levin attorney Dianne Bourque is quoted regarding the aggressive new Texas health care privacy law.
The Center for Medicare and Medicaid Innovation has extended the deadlines for submitting  letters of intent and final applications for participation in the Bundled Payments for Care Improvement Initiative. 

Medicaid RACs: Coming Soon to a State Near You

September 15, 2011 | Blog | By Brian Dunphy, Karen Lovitch

Eliminating fraud, waste, and abuse in health care has long been a top government priority, but — as demonstrated by a series of events this week — it likely will garner even more attention as the government seeks to reduce the federal deficit by $1.5 trillion over the next ten years. Providers should closely monitor the developments.

ML Strategies Weekly Health Care Reform Update

September 14, 2011 | Blog | By Karen Lovitch

ML Strategies has posted its weekly Health Care Reform Update providing timely information on implementation of the Affordable Care Act and other state and federal administrative and legislative activities related to health care reform.
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