- Discuss select Advisory Opinions from last year on a variety of topics, including use of
Medicare and Medicaid
Medicare Telehealth Flexibilities Extended
By Eric Fader on
On December 23, the U.S. Congress passed the “Consolidated Appropriations Act, 2023,” the omnibus budget bill for fiscal year 2023 (HR 2617). The bill includes several provisions relating to Medicare coverage of telehealth, including extending some of the flexibilities that became effective at the beginning of the COVID-19 pandemic.
The budget bill for…
OIG Advisory Opinion Promotes Hospital Use of NPs
By Ada Janocinska on
The U.S. Department of Health and Human Services’ Office of Inspector General (OIG) recently issued a favorable Advisory Opinion on a hospital arrangement in which the hospital was using its employed nurse practitioners to perform services that were traditionally performed by patients’ attending physicians. Specifically, if the attending physician elected to participate in the hospital’s…
Pharma Coalition Files Suit Against HHS over OIG Advisory Opinion
On November 9, the Pharmaceutical Coalition for Patient Access (PCPA) filed an action against the U.S. Department of Health and Human Services (HHS) after HHS’s Office of Inspector General (OIG) determined that a proposed patient assistance model posed more than a minimal risk of fraud, waste, and abuse under the federal Anti-Kickback Statute (AKS). PCPA…
Avoiding the Pitfalls in Recent Government Enforcement
In the next installment of Rivkin Radler’s Healthcare Compliance Lunch & Learn series, Rivkin Radler’s Ben Malerba and Ben Wisher will discuss Avoiding the Pitfalls in Recent Government Enforcement. The program will cover recent audits, investigations and actions of government agencies including DOJ, MFCU, OMIG, the NY AG, and others. Ben and Ben will also…
Connecticut Doctor Pleads Guilty to Fraud and Kickbacks
By Eric Fader on
The U.S. Attorney’s Office for the District of Connecticut announced on November 3 that Ananthakumar Thillainathan, a physician with offices in Stratford and Milford, pleaded guilty to healthcare fraud and federal kickback violations. The doctor faces up to 20 years in prison and a restitution payment of almost $1.7 million.
Thillainathan, the owner of MDCareNow…
NY Pharmacy Owners Plead Guilty to Money Laundering During COVID-19
By Ada Janocinska on
The U.S. Department of Justice (DOJ) announced on November 16 that two pharmacy owners from Forest Hills, New York have pleaded guilty to conspiracy to commit money laundering through submission of fraudulent claims to Medicare during the COVID-19 pandemic. The co-conspirators owned over a dozen pharmacies in the New York area, through which they submitted…
CMS Adds New Billing Code for Dental Surgeries
By Eric Fader on
The American Dental Association (ADA) announced on November 15 that the Centers for Medicare & Medicaid Services (CMS) has agreed to create a new Healthcare Common Procedure Coding System (HCPCS) code G0330 for dental surgeries performed under anesthesia in hospital operating rooms. The new code resulted from an advocacy campaign driven by the ADA, American…
The Triple Threat of Workers’ Compensation Fraud
By Rivkin Rounds Staff on
Rivkin Radler’s Michael Sirignano authored an article for the November 3 issue of the New York Law Journal entitled “The Triple Threat of Workers’ Compensation Fraud.” Although the article wasn’t in time for Rivkin Rounds’ recent Fraud Week, it discussed some recent attempts by healthcare providers to game the workers’ comp system by…
Fraud Week: Pharmacy Kickbacks, Fake Medical Directorships and More
Federal and state enforcement activity involving pharmacy fraud tops the list of categories in this edition of Rivkin Rounds’ Fraud Week. We’ll list just a sampling of cases.
On October 19, the U.S. Department of Justice (DOJ) announced that Jerry May Keepers of Kingswood, Texas was sentenced to 36 months of supervised probation for writing…