On June 27, U.S. Attorney General Merrick Garland announced the results of a two-week nationwide law enforcement action by the Department of Justice (DOJ) in 32 federal districts against 193 defendants for their participation in a variety of healthcare fraud schemes. These federal enforcement actions also included the seizure of more than $230 million in
Telehealth
NP Gets Jail Time for DME Fraud Scheme
On April 10, Virginia-based nurse practitioner Daphne Jenkins was sentenced to prison for her participation in a $7.8 million telemedicine fraud scheme that involved medically unnecessary orders for durable medical equipment (DME). As part of the scheme, Medicare claims were submitted based on false documentation and tainted by kickbacks.
The orders Jenkins signed were pre-populated…
2024 Medicare Physician Fee Schedule Extends Telehealth Flexibilities
The 2024 Medicare Physician Fee Schedule final rule, released by the Centers for Medicare & Medicaid Services (CMS) earlier this month, extended certain telehealth-related flexibilities that were implemented during the early days of the COVID-19 pandemic. CMS issued a Fact Sheet summarizing the telehealth updates, as well as other important Medicare policy changes.
Until 2020…
OCR Releases Resource Documents on Telehealth Risks
The U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) recently released two resource documents to help healthcare providers explain the privacy and security risks of telehealth to their patients.
The first document, entitled “Educating Patients about Privacy and Security Risks to Protected Health Information when Using Remote Communication Technologies…
Telehealth Awareness Week
The American Telemedicine Association (ATA) has announced that its third annual Telehealth Awareness Week will take place September 17-23, 2023. The official website for the event states:
“During the week, the ATA invites telehealth solution providers, hospital systems and medical practices, patient advocacy leaders, policymakers, and other stakeholders to highlight the need to establish…
Telehealth After the Pandemic: Recent Federal and State Developments
On Thursday, September 14, in the next installment of Rivkin Radler’s Healthcare Compliance Lunch & Learn series, Rivkin Radler partner Eric D. Fader will present an update on the regulatory landscape for the provision of telehealth services, including recent changes to federal and state laws and rules. The program will take place from 12:00 noon…
Doing telehealth from home? If you’re zoned out, take steps to fix it
A June 12 article in Part B News, “Doing telehealth from home? If you’re zoned out, take steps to fix it,” discussed possible local zoning restrictions on providers who render telehealth services from their homes. Khoren Bandazian, a partner in Rivkin Radler’s Real Estate, Zoning and Land Use, and Health Services Practice Groups…
PHE HIPAA Enforcement Discretion to Expire, Restoring Compliance Obligations
The U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) announced on April 11 that the Notifications of Enforcement Discretion issued under HIPAA and the HITECH Act during the federal COVID-19 public health emergency (PHE) will expire when the PHE ends on May 11.
The four Notifications of Enforcement Discretion that will…
COVID-19 PHE Ending on May 11
As many of our readers are no doubt already aware, the U.S. Department of Health and Human Services announced on February 9 that the COVID-19 public health emergency (PHE) will end on May 11. The announcement gave payers, providers and states 90 days to prepare for policy changes.
As discussed here, most current Medicare…
Fraud Week: So Much Fraud, So Little Time
For those who just can’t get enough fraud, here are some of the “leftovers” from this edition of Fraud Week that your editor thought noteworthy.
Read about a pharmacy biller’s fake copay assistance scheme:
Genetic testing kickback schemes
In TX: https://www.justice.gov/opa/pr/laboratory-owners-and-executives-charged-health-care-kickback-scheme
And here’s a big one in GA: https://www.justice.gov/opa/pr/lab-owner-convicted-463-million-genetic-testing-scheme-defraud-medicare
DME kickback…
