2012

Just a reminder to New York State Medicaid providers that certifications under the NYS Social Services Law and the Federal Deficit Reduction Act are due no later than December 31.

All New York State Medicaid providers who are required to have a compliance program under Social Services Law Section 363-d must certify that their compliance

On December 2, 2012, Interfaith Medical Center, Inc. (“Interfaith”) filed for chapter 11 bankruptcy protection in the United States Bankruptcy Court for the Eastern District of New York, becoming the latest New York hospital to fall victim to the current economic downturn.  It remains to be seen whether Interfaith will be able to

Earlier this week, the Department of Justice announced that it had recovered nearly $5 billion in settlements and judgments under the False Claims Act in fiscal year 2012.  The $4.959 billion figure was a new record for a single year, eclipsing the previous one-year record by $1.7 billion.

In breaking down the $5 billion in

In late October the U.S. Attorney’s Office in the Southern District of New York announced the settlement of a False Claims Act case against Westchester Medical Center (“WMC”) for $7 million, for submitting false reimbursement claims to Medicaid from August 2001 through June 2010 involving outpatient behavioral health services.  The settlement is to be

Some of our colleagues at Farrell Fritz prepared an advisory with helpful information and links for families, individuals and businesses in need of disaster recovery assistance due to Hurricane Sandy or the subsequent storm.

We hope you weathered the storms safely.  Please do not hesitate to contact us if we can be of assistance in

   The Health Information Technology for Economic and Clinical Health Act (the “HITECH”) Act of 2009 aims to have all hospitals and physicians use electronic health records (“EHRs”) for all persons in the United States by 2014.  Federal and State financial incentives, electronic billing requirements, and the need for ever-increasing collaboration and sharing of information among

A post on the KevinMD blog written by Bob Doherty, Senior VP of the American College of Physicians, says that regardless of who wins the 2012 Presidential election, the fee-for-service payment methodolgy to physicians under Medicare may be dead.

The health reform proposals from President Obama and Governor Romney approach Medicare from different angles, but

In this election season, both presidential candidates offer plans to deal with the rising cost of providing health care services, the President’s “Obamacare” by increasing the number of insured individuals through Health Insurance Exchanges, and reducing costs for a continuum of services through Accountable Care Organizations; and Governor Romney by a consumer-driven approach through Medicare

 The New York State Office of the Medicaid Inspector General (“OMIG”) recently finalized regulatory changes to New York State law which relate to the withholding of payments to Medicaid providers when there is a “credible allegation of fraud.”  A credible allegation of fraud is defined as an “allegation that has indicia of reliability and has

Historically, health care services have been paid for by health insurance companies which accept monthly premium payments from employer groups and individuals.  The premium for defined health care services is due whether the insureds under the policy use the benefits or not.  Built into the premiums are additional administrative costs including fees paid to insurance