As of September 30, several temporary Medicare telehealth flexibilities that were put in place during the COVID-19 pandemic officially came to an end. One of the most significant changes involves the site requirement for telehealth services. Medicare beneficiaries can now only receive telehealth services other than behavioral or mental health services from specific originating sites
Nursing Home Company Pays HIPAA Fine for Publicizing Patient Success Stories
By Ada Janocinska on
A company that runs five nursing homes in Delaware recently agreed to pay a $182,000 fine to settle an investigation for alleged HIPAA violations. The U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) investigated the company, referred to collectively as the Cadia Healthcare Facilities, after it received a complaint that the…
Brooklyn Cardiologist Jailed for Fraudulent Office Lease Scheme
By Douglas Menikheim on
The U.S. Attorney’s Office for the Southern District of New York announced on August 21 that Niranjan Mittal, a Brooklyn-based cardiologist, was sentenced to 37 months in federal prison. Mittal pleaded guilty to violating the federal Anti-Kickback Statute (AKS) in connection with a fraudulent scheme that lasted roughly seven years and resulted in over $40…
Failed Restrictive Covenant Case Signals a Warning to Practices
By Rivkin Rounds Staff on
Posted in Employer/Employee, Litigation
An article in the September 22 issue of Part B News, “Failed restrictive covenant case signals a warning to practices,” discussed a recent New Jersey case in which a practice sued to enforce a restrictive covenant against a physician whose employment it had terminated. Rivkin Radler’s Tamika Hardy was quoted in the…
OIG Issues Favorable Advisory Opinion on Donations to Non-Profit Foundation
The U.S. Department of Health and Human Services’ Office of Inspector General (OIG) has issued a favorable Advisory Opinion for a non-profit foundation receiving donations from an affiliated company. The company in this case offers family-based therapy for children with a redacted “Disorder” (presumably autism), where the goal of the therapy sessions is to train…
A History of CDPAP Enforcement at the NYS AG’s Office
By Jeff Kaiser on
New York’s Consumer Directed Personal Assistance Program (CDPAP) has long been the subject of enforcement at the New York State Attorney General’s Office (AG). Many of those enforcement actions involve caregivers who billed Medicaid for CDPAP services never provided but sometimes also implicate agencies that are responsible for processing caregiver payments and protecting against fraud.…
FTC Abandons Non-Compete Ban but Signals Continued Scrutiny
By Norton Travis & Atara Kahn on
Posted in Employer/Employee, Legislation and Public Policy
The Federal Trade Commission (FTC) has formally abandoned its effort to implement a nationwide prohibition on employer non-compete agreements, marking the end of one of the most closely watched regulatory battles in recent years. While the sweeping ban will not take effect, the agency has made clear that restrictive covenant practices remain firmly on its…
How to Handle Payer Record Request and Subsequent Demand for Alleged Overpayments
By Rivkin Rounds Staff on
Posted in Medicare and Medicaid, Private Insurers
On Thursday, September 18, in the next installment of Rivkin Radler’s Health Law Executive Briefings, Chris Kutner and Ashley Algazi will present “How to Handle Payer Record Request and Subsequent Demand for Alleged Overpayments.”
The presentation will provide a comprehensive review of the issues and best practices for responding to, and defending against, payer audits.
NY Insurer Fined $250,000 for Mental Health “Ghost Network”
By Emily Manning & Eric Fader on
The New York Attorney General’s office recently announced an agreement with MVP Health Care under which the insurer will pay $250,000 in penalties, fees, and costs to the state for maintaining an inaccurate mental health provider directory. The settlement is the first arising out of an investigation of so-called “ghost networks” by Attorney General Letitia…
The Changing Face of New York’s Medicaid Home Care Program Cuts Deep
By Wendy Sheinberg & Mohammed Haque on
New York State’s Medicaid Home Care program pays for in-home personal care services. New York’s program has long been the best in the country. One underlying policy behind the program was that people should have every opportunity to remain in the community. A community focus provides two benefits: the social benefit derived from keeping people…