Literature Review
All posts tagged with “Regulatory News | Fraud & Abuse News.”
NAHC President Bill Dombi—History Repeating Itself on Hospice Program Integrity
12/16/23 at 03:18 AMNAHC President Bill Dombi—History Repeating Itself on Hospice Program IntegrityHospice NewsDecember 14, 2023Issues of fraud in the hospice industry echo events that previously affected the home health space, and providers can learn from that prior experience. This is according to Bill Dombi, president of the National Association for Home Care and Hospice, who spoke Thursday in a Relias webinar. ... “What I’m seeing is history repeating itself. Back in the 1990s, the microscope ended up focusing on the Medicare Home Health Program.
US Supreme Court refuses to hear fraud appeal for South Florida health care executive pardoned by Trump
12/14/23 at 03:41 AMUS Supreme Court refuses to hear fraud appeal for South Florida health care executive pardoned by TrumpSouth Florida Sun-SentinelDecember 11, 2023The U.S. Supreme Court on Monday refused to take up an appeal by a South Florida nursing-home operator whose 20-year prison sentence was commuted by former President Donald Trump after being convicted in what prosecutors called a “massive health care fraud scheme.” The Supreme Court rejected a petition by attorneys for Philip Esformes, who was found guilty in 2019 on 20 counts related to kickbacks, money laundering, obstruction of justice and conspiracy, according to court documents.
2023’s Most Impactful Hospice Regulatory Moves
12/14/23 at 03:07 AM2023’s Most Impactful Hospice Regulatory MovesHospice NewsDecember 12, 2023Program integrity issues that have heated up in the hospice space during the past five years reached a boiling point in 2023. Hospice providers have seen an array of increased regulatory oversight in 2023. That momentum has been fueled by two main concerns among regulators—risks of patient safety and evidence of malfeasance in the space. Hospice News sat down with providers, advocacy groups, legal experts and other stakeholders to uncover the most significant hospice regulatory trends from this year and their anticipated impacts heading into 2024 and beyond. ...Editor's Note: Quoted in the article, Jason Wallace, partner in health care, Barnes & Thornburg LLP; Ben Marcantonio, COO and interim CEO, NHPCO; Carrie Uebel, senior vice president and chief ethics and compliance officer, Compassus
UnitedHealth hit with Medicare Advantage marketing complaint
12/09/23 at 04:00 AMUnitedHealth hit with Medicare Advantage marketing complaintModern HealthcareDecember 7, 2023Advocates for people with disabilities are calling on regulators [to] halt what they describe as misleading Medicare Advantage marketing by UnitedHealth Group. The Center for Medicare Advocacy, National Health Law Program, Disability Rights Connecticut and National Disability Rights Network wrote the Centers for Medicare and Medicaid Services, the Federal Trade Commission and other state and federal officials Thursday to protest UnitedHealthcare advertisements for Dual Eligible Special Needs Plans appearing in Connecticut. The ads target people with both Medicare and Medicaid and spotlight extra benefits from Medicare Advantage plans that state and federal laws already require, the groups wrote. “Unquestionably, this misleading advertising is intended to induce, and has induced, thousands if not tens of thousands of older adults and disabled low-income individuals we are charged with representing to sign up for UnitedHealthcare’s plan, having been led to believe this means they can get extra benefits,” the letter says. UnitedHealth Group did not immediately respond to an interview request.
OIG Report - Louisiana nursing home background checks
12/07/23 at 04:00 AMOIG Report - Louisiana Nursing Home Background ChecksPress Release 12/6/23.Louisiana should improve its oversight of nursing homes' compliance with requirements that prohibit employment of individuals with disqualifying background checks.
Government expects to recover more than $3B from healthcare fraud, misspent funds in fiscal year 2023
12/06/23 at 04:00 AMGovernment expects to recover more than $3B from healthcare fraud, misspent funds in fiscal year 2023Healthcare DiveDecember 4, 2023The HHS’ Office of the Inspector General is expected to recover more than $3.44 billion in fiscal year 2023 as a result of investigations into fraud and misspent funds in Medicare, Medicaid and other government health programs, according to the agency’s latest report.
OIG FY 2022 Health Care Fraud and Abuse Control Program Annual Report
12/04/23 at 04:00 AMOIG FY 2022 Health Care Fraud and Abuse Control Program Annual ReportPress Release 11/14/23OIG publishes the Health Care Fraud and Abuse Control Program Report for Fiscal Year 2022 and posts two enforcement actions. Three hospice actions in this report (download report and search for "hospice").
A Broward hospice nurse stole from a widow-to-be. She’s living and licensed in New York
12/01/23 at 04:00 AMA Broward hospice nurse stole from a widow-to-be. She’s living and licensed in New York