Year: 2022
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Provider Alert: Department of Justice to Target Executive Compensation to Curb Healthcare Fraud and other Corporate Crime
The DOJ recently announced a policy of withholding “cooperation credit” for healthcare entities who fail to “claw back” executive compensation after a finding of wrongdoing. This policy is a strong reminder that all healthcare entities must have a strong compliance plan in place and diligently investigate health care fraud and false claims allegations.
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Government gets $16 million in Urine Drug Testing False Claim Case: Here’s How You Avoid This Common Healthcare Compliance Pitfall
One of the most frequent problems we encounter during our audits of physician practices is the structure of the practice’s urine drug testing program. We all know that the CDC guidelines and many state regulations require practices prescribing controlled substances to conduct a urine drug test on nearly all patients at regular intervals. In typical government fashion, the Government is taking a swing at providers who are testing too much in the form of civil and criminal action. Anecdotally, as a litigator I am leading the defense of a number of physicians who are on the wrong end of federal healthcare audits for doing what they thought was the right thing, conducting urine drug tests and confirming the results. That’s why I founded CCG – to give you the right compliance advice before you are the target of federal scrutiny. Our goal is to help steer practices in the right direction BEFORE the federal government starts poking around – or worse! Here’s how you can avoid civil and criminal investigation related to your urine drug testing program.
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Provider Alert: Department of Justice to Target Executive Compensation to Curb Healthcare Fraud and other Corporate Crime
The DOJ recently announced a policy of withholding “cooperation credit” for healthcare entities who fail to “claw back” executive compensation after a finding of wrongdoing. This policy is a strong reminder that all healthcare entities must have a strong compliance plan in place and diligently investigate health care fraud and false claims allegations.
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Three Important DOJ Memos: The Sessions Memo, Brand Memo, and Garland Memo
In Allina v. Azar the Supreme Court determined that agency guidance that does not undergo the formal rulemaking process cannot be binding on private entities. This was a landmark decision and halted the use of the use of such documents in healthcare fraud and false claims act cases.
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Provider Alert: Your Urine Drug Testing Program May Not Be Compliant, Here’s Why…
Urine drug testing is commonly used in healthcare practices to ensure patients are compliant with their medication and not diverting or abusing medication and illicit substances. Many states have implemented drug testing requirements that providers must follow.
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Chapman Consulting Group: The Blueprint to Ironclad Healthcare Compliance
I have spent the last decade of my career practicing healthcare compliance and fighting hard against the federal government in healthcare fraud and false claims act litigation. While I have been fortunate with a number of trial victories and favorable settlements, I became increasingly frustrated at the collateral damage inflicted upon unsuspecting healthcare providers.
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Azar v. Allina: The Truth About Medicare Coverage Determinations, LCD’s and NCD’s
Local Coverage Determinations (“LCDs”) are issued by Medicare Advantage Contractors (“MACs”), which are nothing more than interpretive guidance that do not go through formal rulemaking process. The U.S. Supreme Court recently held in Azar v. Allina Health Services that interpretive guidance does not bind health care providers unless promulgated through the notice-and-comment procedures required by the Medicare statute—which the LCDs were not.
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Changes to the Anti-Kickback Statute’s Personal Services Safe Harbor and Value-Based Care Models
The Office of Inspector General (“OIG”) modified the personal services and management contracts safe harbor of the federal Anti-Kickback Statute (“AKS”) earlier this year. These modifications expand protections to payment structures that incorporate value-based care models.