Category: Medicare

OIG Has Tried to Encourage CMS to Close a Drug Payment Loophole Twice, But CMS Won’t Budge

Government oversight can sometimes be a frustrating business.  That maxim is particularly true when it comes to persuading the Centers for Medicare & Medicaid Services...

Inpatient Psychiatric Facilities are Overpaid for Unnecessary Outlier Payments

At the end of the day, virtually all of the Medicare program – and any health insurance plan for that matter – relies on the...

Providing Travel and Lodging to Patients Prescribed Certain Drugs is Not Necessarily Pharmaceutical Fraud

The most common answer you will get when you ask a lawyer a question is, “It depends.”  While that answer is not always the most...

New OIG Report Raises Concerns That Health Risk Assessments May Be Source of Improper Medicare Advantage Payments

As part of its watchdog function, the OIG confirmed in its 2020 report  that  payments made through the Medicare Advantage program were improperly inflated to...

Hospitals in Trouble for Improperly Billing Medicare and Medicaid Health Care Programs

St. Michael’s Medical Center in Newark, New Jersey recently resolved allegations with the Department of Justice that it falsely billed Medicare and Medicaid for medically...

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