Medicare and Medicaid

In a report published on March 31, the U.S. Government Accountability Office (GAO) recommended that the Centers for Medicare & Medicaid Services (CMS) begin to collect and analyze information about any effect telehealth has on the quality of care for Medicaid beneficiaries. CMS does not currently collect or analyze this information, nor does it have

At the beginning of the COVID-19 pandemic, the Centers for Medicare & Medicaid Services expanded Medicare coverage for telehealth nationwide, as discussed here. The $1.5 trillion omnibus spending bill signed into law by President Biden today extended the current telehealth accommodations for 151 days after the end of the federal public health emergency, which

The U.S. Department of Justice (DOJ) announced on March 3 that Ameet Goyal, M.D., a Westchester-based ophthalmologist, was sentenced to 96 months in prison for falsely billing for millions of dollars of upcoded procedures over seven years, and for fraudulently obtaining two business loans under the CARES Act’s Paycheck Protection Program (PPP) in the early

Rivkin Radler’s Michael Sirignano wrote an article, “The Opioid Crisis: An Epidemic Exacerbated by Fraud,” that appeared in the March 3 issue of the New York Law Journal. The article discussed the various types of opioid fraud, including illegal distribution, fake prescriptions, illegal dispensing by pharmacies, and medically unnecessary procedures.

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We don’t often cover brand-new proposed legislation on Rivkin Rounds, generally preferring to wait until it’s closer to becoming law. However, two bipartisan bills introduced in Congress last week are worthy of mention.

The Telehealth Extension and Evaluation Act would allow the Centers for Medicare & Medicaid Services to extend certain pandemic-era flexibilities in Medicare

On Thursday, January 13, in the next installment of Rivkin Radler’s Healthcare Compliance Lunch & Learn series, Rivkin Radler Partner Robert Hussar will present a review of key developments in healthcare fraud and abuse, compliance and government enforcement in 2021 as well as trends and changes in the industry that will impact healthcare organizations and

Rivkin Radler’s Michael Sirignano wrote an article, “An Insurance Fraud Year in Review,” that was published in the January 6 issue of the New York Law Journal. Among the many cases and settlements discussed were False Claims Act cases involving federal healthcare programs, healthcare fraud related to COVID-19 testing and telehealth services,

On January 7, the U.S. Supreme Court will hear oral arguments pursuant to emergency requests in two cases concerning COVID-19 mandates. One case involves a challenge by a coalition of interest groups and states opposed to the Occupational Safety and Health Administration’s mandate, which requires employees of businesses with 100 or more employees to receive

Many of the changes to telehealth requirements during the COVID-19 pandemic on both the federal and state levels were intended to be temporary, as previously discussed here. Recently, a bipartisan group of lawmakers in Congress introduced the Telehealth Extension Act, which would, among other things, eliminate the requirement that patients live in a

The U.S. Department of Justice (DOJ) announced that Flower Mound Hospital Partners LLC, a partially physician-owned hospital in Flower Mound, Texas, agreed to pay $18.2 million to settle its alleged violations of the False Claims Act (FCA). The DOJ alleged that the hospital knowingly violated the FCA by submitting claims to Medicaid, Medicare, and TRICARE