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The United States Centers for Medicare and Medicaid Services (CMS) made many changes to its rules in response to the current coronavirus pandemic. Three that directly impact healthcare include: Telehealth. Although CMS has covered telehealth services in the past, it...
The United States Centers for Medicare and Medicaid Services (CMS) recently announced changes to its Next Generation Accountable Care Organization (ACO) program. CMS explains these changes are an attempt to continue sufficient financial incentives to encourage higher...
Lawmakers designed the federal Anti-Kickback Statute (AKS) to help better ensure medical professionals focus on the well-being of their patients. Lawmakers intended this piece of regulation to reduce the risk of medical decisions based on financial gain. But what...
The current coronavirus pandemic has led various federal government programs to provide funds to struggling businesses. Some of these funds are set aside specifically for health care businesses. These funds often come with restrictions and improper use can result in...
Running a lab is a rewarding and difficult profession. In some cases, there are business considerations. Contracts may govern these arrangements. In a recent case, a lab owner accused a hospital of failing to fulfill its agreements as listed within the contract. The...
The United States Centers for Medicare and Medicaid Services (CMS) sent out federal funding to help qualifying businesses within the health care marketplace. These funds were part of the Coronavirus Aid, Relief and Economic Security Act. In an effort to better ensure...
The United States Department of Justice (DOJ) recently announced criminal charges against two New England men. The agency claims the men were attempting to defraud the government’s recently unveiled small-business lending program — a program lawmakers...
How pharmacies classify and pay their workers can cause questions and may lead to a federal investigation. A recent case provides an example. Issue #1: One pharmacy or two? The prosecution states the pharmacy owners claimed to have two separate pharmacy businesses. In...
A recent case provides an example of how the government moves forward with a case of health care fraud that may involve an unlikely offender and the types of penalties that can apply. According to the Federal Bureau of Investigation (FBI), the accused in this case was...
An ear, nose and throat (ENT) practice recently agreed to pay the government along with local state authorities over $9 million to settle claims they violated the federal False Claims Act (FCA) and state regulations.The allegations involved an improper financial...