On July 30, 2019, a federal jury in Detroit, Michigan, found a patient recruiter guilty for his role in a scheme involving approximately $1.3 million in fraudulent Medicare claims for home health care that were procured through the payment of illegal kickbacks. Following a six-day trial, Dominic Trumbo, 45, of Lexington, Kentucky, was found guilty […]
This year, key information regarding the Appropriate Use Criteria (AUC) program is being released by the Centers for Medicare & Medicaid Services (CMS) via guidance documents. A Change Request was issued July 26, 2019, informing Medicare Administrative Contractors (MACs) that they are to begin accepting AUC-related modifiers and healthcare common procedure coding system (HCPCS) codes […]
On July 10, 2019, United States Attorney Matthew Schneider announced the indictment of Dr. Vasso Godiali of Bay City, charged with health care fraud in the amount of $60 million, and money laundering for financial transactions involving approximately $49 million in proceeds derived from the scheme. According to the indictment, Dr. Godiali submitted false and […]
Anyone practicing midwifery in the State of Michigan will be required to be licensed in midwifery beginning August 1, 2019. The Department of Licensing and Regulatory Affairs (LARA) began accepting applications on May 6, 2019. Under Public Act 417, which established Part 171 in the Public Health Code, an individual may not engage in the […]
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 […]
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