An interesting SDNY settlement agreement resolves some False Claims Act allegations, but leaves others for another day. Visiting Nurse Service of New York (VNS) paid just under $35 million to the United States and New York State to settle allegations that VNS improperly billed Medicaid for 1,740 members whose needs did not qualify for a
Proposed “Fairness” Amendments to the False Claims Act
Earlier this month, a bill to amend the False Claims Act (“FCA”), the “Fairness in Health Care Claims, Guidance and Investigations Act,” was introduced in the House of Representatives. According to one of the bill’s sponsors, Rep. Howard Coble (R-NC), the bill’s purpose is to ensure that unintentional billing disputes are not penalized as
Photocopiers and HIPAA – Health Plan Settles with HHS for $1.2 Million
Is your office photocopy machine a HIPAA time-bomb? Affinity Health Plan recently learned that the answer is yes, to the tune of a $1.2 million settlement with the US Department of Health and Human Services Office for Civil Rights (OCR). Affinity is a not-for-profit managed care organization which includes one of the New York metropolitan
Hannon, Helgerson to speak on Medicaid Redesign
Senator Kemp Hannon, Chair of the New York State Senate Committee on Health (and counsel at Farrell Fritz), will be hosting a health care forum featuring a presentation by State Medicaid Director Jason Helgerson. The event will take place on Monday, August 5 from 10:00 am to noon at the Hofstra University Student Center Theatre.
Feds to Offer Free HIPAA Compliance Webinars
The Office for Civil Rights of the US Department of Health and Human Services, in conjunction with the Workgroup for Electronic Data Interchange (“WEDI”), has announced a series of four free webinars on compliance with the latest Omnibus HIPAA/HITECH final rule, which implements significant changes in the requirements imposed upon health care organizations, providers, and
First HHS Settlement for Small HIPAA Breach
On January 2, 2013, the US Department of Health and Human Services announced a $50,000 settlement with Hospice of North Idaho for a data breach involving the theft of a lost, unencrypted laptop computer containing the health information of 441 patients.
This settlement is the first for a reported breach affecting fewer than 500 individuals.
Compliance Certifications Due By 12/31
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
Are Mandatory Price Controls the Answer to America’s Health Care Woes?
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
OMIG to Withhold Payments for “Credible Allegations of Fraud”
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
Medicare Issues in Bankruptcies
In its August 2012 issue, the American Bankruptcy Institute Journal published Medicare Issues in Bankruptcies by Ted Berkowitz and Veronique Urban of Farrell Fritz.
The takeaways:
-Health care entities contemplating a bankruptcy filing should carefully consider the effects that the filing will have on their Medicare arrangements;
-Health care debtors should be aware that any