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- Audience: Management Services Organizations
Alerts
OIG Issues New Resource for Single Audits
The United States Department of Health and Human Services (HHS), Office of Inspector General (OIG) recently posted a new educational resource on its website about Single Audits. HHS is the largest grant-making agency in the Federal government, and OIG’s new resource is designed to help key stakeholders understand the scope of Single Audits, as well as improve the overall quality of such audits.
Alerts
OIG Approves Creative Approach to Restructuring Medical Practice Partnerships
The U.S. Department of Health and Human Services, Office of Inspector General (OIG) posted a favorable Advisory Opinion (23-12) that allows a limited liability partnership (the Partnership) consisting of two classes of physician partners to make a one-time, voluntary redemption offer (offer) to individual partners when they reach age 67.
Alerts
OIG Approves Use of Gift Cards for Referrals in Certification-Heavy Advisory Opinion
The U.S. Department of Health and Human Services, Office of Inspector General (OIG) posted a favorable Advisory Opinion (23-15) permitting a consulting company’s (Consultant) proposal to offer gift cards to its current physician practice customers for referring potential new physician practice customers to Consultant. Notably, OIG determined that the proposed arrangement did not implicate the Anti-Kickback Statute (AKS).
Alerts
OIG Issues Toolkit for Medicare Advantage Organizations
The U.S. Department of Health and Human Services, Office of Inspector General (OIG) released a new toolkit to help Medicare Advantage (MA) organizations replicate OIG audit methodologies to detect and correct inaccurate diagnosis codes in their own systems.
Alerts
OIG’s Newest Strategic Plan Prioritizes Managed Care Oversight
The U.S. Department of Health and Human Services, Office of Inspector General (OIG) recently designated oversight of managed care as a “priority area”, and developed a coordinated strategic plan (the Plan) to better align its audits, evaluations, investigations, and enforcement of managed care.
Alerts
OMIG’s 2024 Work Plan Gives Critical Insights into Program Integrity Initiatives
The New York State Office of the Medicaid Inspector General (OMIG) released its 2024 work plan in furtherance of its mission to coordinate and conduct activities to prevent, detect and investigate medical assistance program fraud, waste and abuse, and to recover improperly expended Medicaid funds.
Alerts
More Provider “Nuggets” From OIG’s Year-End Reporting Blitz
Continuing its year-end reporting blitz, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) released its Semiannual Report (SAR) to Congress on December 1, 2023.
Alerts
OIG’s Favorable Advisory Opinions Allow Incentives to Medigap Plan Policyholders
The U.S. Department of Health and Human Services, Office of Inspector General (OIG) posted two favorable Advisory Opinions (23-09 and 23-10) to allow a licensed offeror of Medicare Supplemental Health Insurance (Medigap Plan) policies and a preferred health organization (PHO) (collectively, “the requestors”) to incentivize Medigap Plan policyholders to seek inpatient care from a hospital within the PHO’s network. Notably, OIG issued these favorable opinions even though the proposed incentives implicated the Anti-Kickback Statute (AKS) and the Beneficiary Inducement Civil Money Penalty (CMP), and there was no applicable exception or safe harbor.
Alerts
DOJ/HHS Jointly Release "Highlight Reel" Report
This week, the United States Department of Justice (DOJ) and the United States Department of Health and Human Services (HHS) fulfilled its annual statutory obligation by releasing its jointly-authored Health Care Fraud and Abuse Control Program (HCFAC) Report for Fiscal Year 2022.
Alerts
OIG Provides Roadmap to Hot-Button Issues
The OIG fulfilled its annual statutory obligation by releasing its Top Management and Performance Challenges (TMC) document. Providers should take note because the document provides important insight into the specific areas over which HHS (and the OIG) will remain focused.
Alerts
OIG Releases New General Compliance Program Reference Guide
On November 6, 2023, the OIG released its General Compliance Program Guidance, the first in a series of new, non-binding reference guides designed to share information with health care compliance professionals and other health care industry stakeholders
Alerts
Temporary Health Care Staffing Agencies Now Required to Register in New York
In what appears to follow a multi-state trend to protect “temporary” workers, as part of the New York Budget for FY 2023-2024, a new law went into effect that requires any entity that provides temporary staff to health care entities to register with the Department of Health (DOH).
Alerts
Connecticut Signals Increased Scrutiny of Physician Practice Acquisitions
On July 21, 2023, the Executive Director of the Connecticut Office of Health Strategy (“OHS”), sent a letter to Connecticut physicians reminding them of the requirement for certain practice transactions to obtain Certificate of Need (“CON”) approval prior to closing.
Alerts
Payment Error Rate Measurement Program for Florida Medicaid and Chip Providers
On February 17, 2023, Florida Medicaid released a Health Care Alert reminding providers of their obligations under the Centers for Medicare and Medicaid Services (“CMS”) Payment Error Rate Measurement (“PERM”) program.
Alerts
Online Tracking Technologies Can Lead to HIPAA Violations
The Department of Health and Human Services, Office of Civil Rights (“OCR”) has published a Bulletin which officially states that incorporating certain tracking technologies into websites and mobile applications may cause HIPAA violations that could result in breach notification obligations as well as penalties. This includes platforms and services provided by companies like Meta (formerly Facebook) and Google.
Events
Health Care Hot Topics: Florida’s New Minimum Wage Requirements For Medicaid Providers
Garfunkel Wild's Susan St. John discusses the things providers need to know about the new minimum wage requirements, and a new civil cause of action for non-compliance.
Events
Garfunkel Wild Webinar – Handling COVID-19 Employee Vaccinations, Updated Leave Entitlements & Addressing Violations of COVID-19 Protocols
Garfunkel Wild’s Marianne Monroy, Salvatore Puccio, and Lauren Levine will present the webinar “Handling COVID-19 Employee Vaccinations, Updated Leave Entitlements & Addressing Violations of COVID-19 Protocols” on January 26, 2021.
Events
New Jersey Institute for Continuing Legal Education Webcast – 2020 New Jersey M&A Conference
Garfunkel Wild Partner/Director Steven R. Antico will present at the New Jersey Institute for Continuing Legal Education Webcast – 2020 New Jersey M&A Conference on October 28, 2020.
Events
Garfunkel Wild Webinar – Returning to Work in the COVID-Era: Employee Issues, What to Expect and How to Prepare
Garfunkel Wild’s Andrew Zwerling, Marianne Monroy, Salvatore Puccio and Lauren Levine will present the webinar “Returning to Work in the COVID-Era: Employee Issues, What to Expect and How to Prepare” on June 12, 2020.
Events
Connecticut Orthopaedic Society (COS) Webinar – COVID-19 Crisis: How Can You Exit or Modify a Contract You Can No Longer Afford or Comply With?
Barry B. Cepelewicz will present at the COS Webinar – Covid-19 crisis: How Can You Exit Or Modify a Contract? On April 23, 2020.
Events
Garfunkel Wild Webinar – An Employer’s Practical Guide To Facing Day-To-Day Coronavirus Challenges
Garfunkel Wild’s Andrew Zwerling, Marianne Monroy, Salvatore Puccio, and Lauren Levine will present the webinar “An Employer’s Practical Guide To Facing Day-To-Day Coronavirus Challenges” on April 20, 2020.
Events
Garfunkel Wild Webinar – Navigating A Murky Landscape: An Employer’s Guide To Responding To The Challenges of COVID-19
Garfunkel Wild’s Andrew Zwerling, Marianne Monroy, Salvatore Puccio, and Lauren Levine will present the webinar “Navigating A Murky Landscape: An Employer’s Guide To Responding To The Challenges of COVID-19” on March 30, 2020.
Events
2nd Annual Center for Health Education, Medicine, & Dentistry (CHEMED) Conference on Medicine & Ethics
Jeffry Adest will present at the 2nd Annual Center for Health Education, Medicine, & Dentistry (CHEMED) Conference on Medicine & Ethics on February 14, 2020.
Events
Monroe County Medical Society Webinar Survival: HIPAA Webinar
Stacey Gulick will present at Monroe County Medical Society Webinar Survival Series: HIPAA Webinar on September 26, 2019.
Events
Fairfield County Medical Association’s (FCMA) Webinar – Navigating Sexual Harassment in the Workplace for Managers and Supervisors
Marianne Monroy and Salvatore Puccio will present at the FCMA’s Webinar – Navigating Sexual Harassment in the Workplace for Managers & Supervisors on May 9, 2019.