My Daughter’s Depiction of Health Care Enforcement — I Call it Enforcica — One of the more challenging and rewarding aspects of being a health care attorney is taking a complex regulated environment and breaking it down in a way that is understandable, regardless of the audience. In the compliance world, this means communicating the rules… Continue Reading
Category Archives: Fraud
Subscribe to Fraud RSS FeedView the OIG HEAT Provider Compliance Training Webcast
Posted in Administration, Enforcement, False Claims Act, Fraud, Government Initiatives, Medicaid, Medicare, OIG, ReformOIG has posted a webcast of its HEAT Provider Compliance Training. It is 3 hours, 45 minutes long. I will post a summary in the near future. There is also an OIG HEAT Provider Compliance Training Website at which you can download the corresponding slides and related materials. Get Instant Updates by Email
OIG’s HEAT Provider Compliance Training
Posted in Administration, CMS, DOJ, Enforcement, False Claims Act, Fraud, Government Initiatives, Medicaid, Medicare, OIG, Stark LawSince February 2011, members of the HHS Office of Inspector General (OIG) and their colleagues have been presenting HEAT Provider Compliance Training across the country. The most recent training included a live webcast with slides. The OIG has committed to posting a link to the webcast by the end of May. In the meantime, the slides… Continue Reading
Interview of Tony West, Asst. Attorney General, Civil Division, DOJ
Posted in Administration, DOJ, Enforcement, False Claims Act, FERA, Fraud, Government Initiatives, Implantable Cardiac Devices, Medicare, ReformI recently interviewed Tony West, who is the Assistant U.S. Attorney General, Civil Division, of the Department of Justice. The Civil Division is responsible for the government’s cases involving health care fraud and challenges to the health care reform law. He is, of course, heavily involved in the DOJ’s HEAT initiative. The interview provides insight into current government… Continue Reading
New Healthcare Compliance App
Posted in Enforcement, False Claims Act, Fraud, ICD, Implantable Cardiac Devices, Medicaid, Medicare, News, OIG, RACs, Reform, Settlements, Social Networking, Stark Law, StimulusIf you have an iPhone or iPad, you can now access The Healthcare Compliance Blog, presentations, podcasts, Twitter feeds and other helpful information through my new App. Search the App Store for “Compliance Law” or “Sheeder.” Here’s a link to the Apple iTunes listing: http://tinyurl.com/sheederapp/ Kindly let me know what you think. Thanks.
There is Enough Healthcare Enforcement/There is Too Little
Posted in Enforcement, False Claims Act, Fraud, Government Initiatives, Medicaid, Medicare, OIGThe government just reported that it recovered over $4 billion in its fight against healthcare fraud last year. But is it enough? According to The Department of Health and Human Services and The Department of Justice Health Care Fraud and Abuse Control Program Annual Report for Fiscal Year 2010, the government recovered unprecedented amounts in… Continue Reading
Dealing with Government Overpayments
Posted in FERA, Fraud, Government Initiatives, Medicaid, Medicare, ReformHealthcare providers that identify overpayments from government programs like Medicare and Medicaid can violate the False Claims Act if they don’t report and repay within 60 days or the deadline for a corresponding cost report. They may have such exposure even if they received an overpayment innocently. This presentation addresses the applicable legal provisions and… Continue Reading
More Predictions re: Healthcare Enforcement in 2011
Posted in Enforcement, Fraud, Government Initiatives, ICD, Implantable Cardiac Devices, Medicare, ReformIn the previous post, I made four predictions regarding government enforcement initiatives in 2011. Here are three specific areas that hospitals should be concerned about: Hospital relationships with physicians. There have been many settlements in this area, and the government just announced a $30 million settlement with Detroit Medical Center regarding leases and independent contractor… Continue Reading
Required Reading: The Latest CMS/DOJ “Stop Medicare Fraud Summit”
Posted in False Claims Act, Fraud, Government Initiatives, Medicare, ReformOn August 26, CMS and DOJ held a Stop Medicare Fraud Summit in Los Angeles. HHS Secretary Kathleen Sebelius gave remarks, as did Attorney General Eric Holder and others. Here are some key statements. The complete speeches are available by clicking on the names of the officials. HHS Secretary Kathleen Sebelius: But with our annual… Continue Reading
Seeking $50 Billion by 2012, President Signs Improper Payments Elimination and Recovery Act
Posted in Administration, FraudHere is more required reading, this time from the White House. It means even more job security for compliance professionals. This is also consistent with my theme about the relationship between reform and enforcement, though this is not aimed solely at healthcare payments. Today, President Obama will sign the Improper Payments Elimination and Recovery Act… Continue Reading
Frank Sheeder
Frank Sheeder, chair of DLA Piper's Health Care Enforcement and Compliance practice, has defended clients against civil and criminal fraud allegations brought by the government and other hostile third-party litigants – especially whistleblowers – for more than 20 years... Read More