The Michigan Department of Licensing and Regulatory Affairs (LARA) recently launched a new licensing platform for physicians (MDs and DOs) and 10 other licensed professions called the Michigan Professional Licensing User System (MiPLUS). The new system is intended to provide an improved interface for licensees and consumers and reduce mailing delays. All professional licensees will […]
IMPORTANT NEWS FOR HOME HEALTH AGENCIES – In a fact sheet released July 11, 2019, the Centers for Medicare & Medicaid Services (CMS) detailed its annual update to the Medicare rate, as well as its plan for the implementation of the Patient-Driven Groupings Model (PDGM) and other proposals for calendar year (CY) 2020, which can […]
By Adrienne Dresevic, Esq. of The Health Law Partners, P.C., Olivia Dresevic JD expected 2020 On June 1, 2019, Joanne Chiedi assumed the role of Acting Inspector General at the U.S. Department of Health and Human Services (HHS) following Daniel R. Levinson’s resignation. Ms. Chiedi recently sat down with the Compliance Perspectives Podcast to speak […]
On June 17, 2019, the Centers for Medicare & Medicaid Services (CMS) announced a settlement option for certain IRF appeals pending at any of the four fee-for-service Medicare administrative appeals levels: the Medicare Administrative Contractor (MAC), qualified independent contractor (QIC), the Office of Medicare Hearings and Appeals (OMHA) Administrative Law Judge (ALJ), and/or the Medicare […]
The Office of Medicare Hearings and Appeals (OMHA) has announced an expansion of the Settlement Conference Facilitation (SCF) program available to the appellant community as of June 7, 2019. Previously, the option of an SCF was only available to appeals filed on or before November 3, 2017. An SCF is “an alternative dispute resolution process […]
Section 1557 of the Affordable Care Act (ACA) is the nondiscrimination provision that prohibits discrimination on the basis of race, color, national origin, sex, age, and disability in any health program that receives federal funding. On May 24, 2019, the Department of Health and Human Services (HHS) proposed a new rule that would maintain vigorous […]
Following a circuit split over the statute of limitations on whistleblower actions, the Supreme Court (SCOTUS) issued a unanimous decision on May 13, 2019. This decision held that, regardless of government intervention, a longer statute of limitations may apply to qui tam lawsuits under the False Claims Act (FCA). Two types of limitation periods govern […]
In order to secure a new Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO) contractor, the Centers for Medicare and Medicaid Services (CMS) has temporarily paused both Short Stay and Higher Weighted Diagnosis-Related Group (HWDRG) reviews. Previously, two BFCC-QIOs have performed HWDRG reviews since 2014 and Short Stay reviews since 2015 for all 50 […]
As of April 30, 2019, the maximum penalties for violations of the Health Insurance Portability and Accountability Act (HIPAA) have new annual limits. These updated penalties will be based on the level of culpability associated with the violation, according to the Department of Health and Human Services (HHS). Organizations that have taken measures to meet […]
The former CEO of a hospital chain that was headquarted in Naples, Florida has agreed to pay $3.46 million to settle allegations that he caused the hospital to knowingly submit false claims to government health care programs. Gary D. Newsome was the CEO of Health Management Associates (HMA) from September 2008 to July 2013, during […]
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