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OCR Settles Tenth Investigation in HIPAA Right of Access Initiative
Riverside Psychiatric Medical Group (“RPMG”) has agreed to take corrective actions and pay $25,000 to settle a potential violation of the HIPAA Privacy Rule’s right of…
OIG Semiannual Report to Congress
OIG issued its Semiannual Report to Congress summarizing the activities of the Department of Health and Human Services (HHS), Office of Inspector General (OIG), for the…
Justice Department accuses Anthem of Medicare fraud
Yet another allegation of Medicare Advantange risk adjustment fraud, this time by Anthem. I wrote about the government’s case against Cigna here. The case alleges that…
CMS Encourages Faster COVID-19 Diagnostic Testing
CMS is changing its payment methodology to encourage higher throughput of COVID-19 diagnostic testing. Previously, CMS would reimburse $100 per test Starting January 1, 2021, Medicare…
DOJ sues Cigna, alleging $1.4B in Medicare Advantage fraud
Cigna falsified the health conditions of its Medicare Advantage plan members to coax CMS into making larger payments to the insurer on behalf of beneficiaries, a…
CMS Issues Cease and Desist Orders to Uncertified Labs Performing COVID-19 Testing
Since August 12, 2020, CMS issued 171 cease and desist letters to entities across the U.S. that were testing for COVID-19 without the appropriate certifications under…
Data Breaches Can Result in Federal and State Liability
Regulatory bodies continue to impose severe penalties on covered entities who fail to protect patient data from unauthorized disclosure. Community Health Systems, Inc. recently settled claims…
Two charged in prescription and kickback scheme
An 11-count indictment unsealed on Friday charges former Kindred Home Health employee Amber Price, 37, and Christopher Cruz, 46, owner of a medical marketing business, CP…
Medical Device Maker to Pay $18 Million to Settle Allegations of Improper Payments to Physicians
This is not a Texas company, but it is a good example of how some manufacturers try to cloak improper payments under the veil of legitimate…
OCR Settles Eighth Investigation in HIPAA Right of Access Initiative
Since 2019, the Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services (HHS) has been prioritizing enforcement actions against covered entities…