By Mark Spivey
The project will focus closely on those struggling with issues associated with the social determinants of health (SDoH). The Atlanta-based Morehouse School of Medicine has been selected as the recipient of $40 million in federal funding to help ramp up the fight against COVID-19 in racially and ethnically diverse, rural,…
June 25, 2020
By David M. Glaser, Esq. PHE: Is the End in Sight?
During a recent Monitor Mondays broadcast, a listener, Rebecca, sent a question asking about the anticipated July 24 expiration of the federal public health emergency (PHE); specifically, she wanted to know about how much to worry about it. My first reaction was that she was wrong, and that the public…
By Mark Spivey
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…
January 16, 2020
By Knicole C. Emanuel Esq. Are ALJ Appointed Properly, per the Constitution?
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…
December 20, 2019
By Timothy Powell, CPA CHCP Special Bulletin: OIG Looks at Medicare Advantage Risk Score Audits
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.…
October 24, 2019
By Timothy Powell, CPA CHCP Identity Theft in Long-Term Care
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,…
By Mark Spivey
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…
By Chuck Buck
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…
By Mark Spivey
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…
By Mark Spivey
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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