Medicare and Medicaid

Exceltox Laboratories, LLC, a California diagnostic laboratory, is paying a $357,584 settlement to resolve allegations of False Claims Act (FCA) violations. Exceltox allegedly submitted or caused to be submitted claims for genetic tests to Medicare without valid physician oversight.

In 2015, Exceltox engaged an independent contractor, Seth Rehfuss, who persuaded residents of low-income senior housing

The U.S. Department of Justice (DOJ) announced on February 1 that an owner and operator of Arbor Homecare Services LLC and a nurse employed by the home health agency were indicted for their roles in a scheme to defraud MassHealth and Medicare of at least $100 million. The Massachusetts agency allegedly routinely billed the government

The U.S. Department of Justice (DOJ) announced on January 28 that athenahealth Inc., a Massachusetts-based electronic health records (EHR) technology vendor, has agreed to pay $18.25 million to resolve allegations that it paid illegal kickbacks to generate sales of its EHR product, athenaClinicals. The settlement is the government’s latest reminder that marketing initiatives that are

The Centers for Medicare & Medicaid Services (CMS) recently released corrections to its 2021 Physician Fee Schedule final rule that was published on December 28. Some of the corrections clarify reimbursement requirements for remote patient monitoring (RPM), which entails gathering and interpreting physiologic data from patients at home.

The December 28 final rule had stated

On January 12, the U.S. Department of Health and Human Services (HHS) released a final rule on “Transparency and Fairness in Civil Administrative Enforcement Actions.” The rule, which was effective immediately, states that HHS can rely only on statutes and regulations in bringing civil enforcement actions. Standards set forth in agency guidance documents

In his 2021 State of the State Address on January 10, New York Governor Andrew Cuomo announced legislation to expand access to telehealth. The proposals will adjust reimbursement incentives to encourage telehealth, relax or eliminate outdated regulatory restrictions on the delivery of telehealth services, and establish training programs for patients and providers and other programs

On December 21, New York State Attorney General Letitia James announced a $6 million settlement of a civil healthcare fraud lawsuit against A.R.E.B.A-Casriel, Inc. d/b/a Addiction Care Interventions Chemical Dependency Treatment Centers (ACI) and its former owner and CEO, Steven Yohay. ACI will pay $3 million and Yohay will pay an additional $3 million personally