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- Audience: Licensed Clinics and Facilities
Alerts
OIG Allows Patient Assistance Programs Funded by Drug Manufacturers
The U.S. Department of Health and Human Services, Office of Inspector General (OIG) posted a favorable Advisory Opinion (24-02) permitting a non-profit organization (Non-Profit) to provide financial support to eligible patients with specific rare diseases through assistance programs (Programs) it operates.
Alerts
FQHC Look-Alike Application Blackout Period: Changes are Coming
The Health Resources and Services Administration (HRSA) has announced that it will not be accepting Federally Qualified Health Center (FQHC) Look-Alike Initial Designation (LAL-ID) applications for approximately one month starting in late June.
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
New York OMIG Updates Self-Disclosure Guidance
The New York State Office of the Medicaid Inspector General (OMIG) recently updated its Self-Disclosure Guidance and Frequently Asked Questions (collectively, “Updates”). These Updates give participating providers and entities additional insight into how to report overpayments involving unresponsive Medicaid Managed Care Organizations (MMCOs) or multiple entities, as well as those that are untimely, have adjusted or voided claims, or lost or damaged records.
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
OIG Finds Lab to Lab Technical Component Arrangement Poses Anti-Kickback Risk
In Advisory Opinion No. 23-06, the U.S. Department of Health and Human Services’ Office of the Inspector General (OIG) declined to approve a proposed arrangement in which an anatomic pathology laboratory operator would purchase the technical component of anatomic pathology services from Physician and Non-Physician Laboratories for commercial payors.
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
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
The Office of Inspector General Updates Its Work Plan for Evaluation, Inspection & Audit of Inpatient Rehabilitation Facilities, Medicaid Managed Care Plans, and Hospitals
The Office of Inspector General (“OIG”) recently updated its Work Plan to include concerns with: inpatient rehabilitation facilities (“IRF”), a focus on Fraud Referrals with Medicaid Managed Care Plans, and audits on hospital price transparency. Below is a summary of the updates to the Work Plan.
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 – Federal No Surprises Act – One Month In. What Have We Learned? What Questions Remain?
Garfunkel Wild’s Debra Silverman and John Martin will present the webinar “Federal No Surprises Act – One month in. What have we learned? What questions remain?" on February 1, 2022, from 12:00 pm – 1:00 pm (EST).
Events
Leading Age Annual Meeting
Garfunkel Wild Partner Director Debra Silverman will present at the Leading Age Annual Meeting on October 25, 2021.
Alerts
New Disclosure Requirement for NY Residential Health Care Facilities
Effective October 1, 2021, residential health care facilities in New York will be required to provide potential residents and their families with a separate document, in no less than twelve point font, as part of their admission packet that includes the following information:
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 York State Society of Orthopaedic Surgeons Virtual Annual Meeting and Symposium
Barry Cepelewicz will present at the New York State Society Of Orthopaedic Surgeons Virtual Annual Meeting and Symposium – November 7, 2020.
Alerts
New York Physician Practice Settings Must Inform Patients How To Report to OPMC
In legislation enacted on October 7, 2020, New York State is requiring physicians’ practice settings to post notice, visible to patients, that direct patients to the Office of Professional Medical Conduct’s (“OPMC’s”) website to obtain information about their rights and how to file a complaint regarding professional misconduct. The requirement is effective immediately.
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
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
Garfunkel Wild Webinar – COVID-19 Billing for Telemedicine Services and Q&A Session
Garfunkel Wild Partner/Director Debra A. Silverman and Partner Stacey L. Gulick along with Certified Professional Coder and President of ProCode Compliance Solutions, LLC, Alicia Shickle will present the webinar “COVID-19 Billing for Telemedicine Services and Q&A Session” on March 25, 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
Greater New York Hospital Association (GNYHA) Webinar – Clinical Trial Agreements
Lara Jean Ancona will present at the Greater New York Hospital Association’s (GNYHA) Webinar – Clinical Trial Agreements on January 15, 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
Nassau County Bar Association (NCBA) Hospital and Health Law Committee CLE – Recent Trends in Health Care Fraud Investigations
John G. Martin and Robert A. Del Giorno will present at the Nassau County Bar Association’s CLE – Recent Trends in Health Care Fraud Investigations on September 17, 2019.
Events
Andrew Blustein was selected as an instructor at The Horizon Foundation for webinar, “Do No Harm: Exploring Strategies for Safer Prescribing of Opioids”.
Andrew Blustein was selected as an instructor at the Horizon Foundation for Webinar, “Do No Harm: Exploring Strategies FOR Safer Prescribing Of Opioids.”
Events
Healthcare Financial Management Association (HFMA) 18th Annual Healthcare Conference
Debra A. Silverman will present at the Healthcare Financial Management Association’s (HFMA) 18th Annual Healthcare Conference on May 22, 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.
Events
Hudson Valley Annual Institute 2019
Andrew l. Zwerling, Marianne Monroy and Salvatore Puccio will present at the Hudson Valley Annual Institute on April 4, 2019.
Events
The Gitenstein Institute for Health Law & Policy at Hofstra University School of Law – Thought Leadership In Action Speaker Series
Judith A. Eisen and Stacey L. Gulick present at the Gitenstein Institute For Health Law & Policy At Hofstra University School of Law – Thought Leadership in Action Speaker Series on April 4, 2019.
Events
BKD CPAs & Advisors’ Webinar – Preparation for Your HRSA Operational Site Visit
Jeffry Adest will present at the BKD CPAs & Advisors’ Webinar – Preparation for your HRSA Operational Site Visit on March 19, 2019.
Events
BKD CPAs & Advisors’ Webinar – CHC/FQHC & Hospital: Opportunities for Strategic Relationships & Synergies
Jeffry Adest will present at the BKD CPAS & Advisors’ Webinar – CHC/FQHC & Hospital: Opportunities for Strategic Relationships & Synergies on February 27, 2019.