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The ousting of Christi A. Grimm comes amid a series of OIG removals, developments that are concerning lawmakers and editorial boards alike.   “The first messenger that gave notice of Lucullus’s coming was so far from pleasing Tigranes, that he had his head cut off for his pains; and no…
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High Court ruling raises questions concerning ALJ appointments. A sneaky and under-publicized matter, which will affect every one of you reading this, slid into common law last year with a very recent case, dated Jan. 9, 2020, upholding and expanding the findings of a 2018 case, Lucia v. SEC, 138…
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MAOs use chart reviews to increase risk-adjusted payments is seen as inappropriate by the OIG.  The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) released a study that should cause a chill to run down the spines of hospital and Medicare Advantage plan leaders alike.…
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There are resources available to help prevent wrongdoers from successfully targeting vulnerable patient populations. A dirty little secret of the long-term care industry is that the problem of identity theft arises more often than is reported.  In all fraud, there is the fraud triangle. The triangle sides are pressure, opportunity,…
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Conspiracy ran for nearly 20 years, netting owner of assisted living and skilled nursing facilities $37 million. The primary orchestrator of what federal authorities called the most wide-reaching healthcare fraud scheme ever uncovered has been sentenced to 20 years in state prison – far short of the 30 years prosecutors…
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Trump’s Executive Order will include a requirement to disclose contracted rates. U.S. Health and Human Services (HHS) Secretary Azar and White House officials held a meeting this morning to explain an executive order that the President plans on releasing today on healthcare price transparency.   Officials said that the executive…
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OIG’s report to Congress profiles plenty of activity, including the ongoing battle against the opioid abuse epidemic. The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) is in the business of rooting out “fraud, waste, and abuse” in the nation’s healthcare system, to echo the…
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Most of those accused of wrongdoing are medical professionals. The national opioid crisis has hit the heart of Appalachia particularly hard, and federal authorities are pulling out the stops in fighting it. U.S. Attorney General William P. Barr and U.S. Department of Health and Human Services (HHS) Secretary Alex M.…
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Two dozen individuals were charged in a landmark investigation historic in breadth. “A million dollars isn’t cool,” remarked pop star Justin Timberlake in the Oscar-winning 2010 film The Social Network, portraying entrepreneur Sean Parker as he advises a young Mark Zuckerberg and his associates in a nightclub amid the fledgling…
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The head of the federal healthcare oversight body was a popular guest on Monitor Mondays. Daniel Levinson, Inspector General of the U.S. Department of Health and Human Services (HHS), is stepping down from his post at the end of May, following nearly 15 years in his position as healthcare’s top…