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CMS Modernizing the Physician Self-Referral and Anti-Kickback Regulations

December 11, 2019Fraud & Abuse

On October 9, 2019, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to modernize and clarify the regulations that interpret the Medicare physician self-referral law (often called the “Stark Law”), which has not been significantly updated since it was enacted in 1989. As CMS tries to reconstruct the healthcare field, it is imperative for compliance programs to prepare for the changes in regulations to come. The following discussion provides a brief overview of the proposed changes but is not an exhaustive list of all rulemakings related to the physician self-referral law.

AKSCMPCMScompliance programHHSOIGRegulationstark

My Summer with the Office of Inspector General for the U.S. Department of Health and Human Services

September 11, 2017Fraud & Abuse

This summer I had the opportunity to intern with the Office of Inspector General for the U.S. Department of Health and Human Services (OIG) in Washington, DC. I thoroughly enjoyed my time with OIG, and I learned a great deal about health care fraud, waste, and abuse. In spending my summer with OIG, I had a glimpse into the powerful regulatory bodies that protect the health care market from abuse. As I move forward with my career in regulatory work, I will take with me the invaluable experiences and skills from my internship.

21st Century Cures ActAnti-Kickback StatuteCenters for Medicare and Medicaid ServicesCivil Monetary Penalties LawCMPCMScorporate integrity agreementDepartment of JusticeDOJEmergency Medical Treatment and Active Labor ActEMTALAfalse claims actFederal health care program exclusionFederal health care programsfraud and abuseHealth and Human Serviceshealth care compliancehealth care fraud and abuseHHSintegrity agreementMACRAMedicaidmedicareMedicare Access and CHIP Reauthorization ActMedicare exclusionOffice of Inspector GeneralOffice of Inspector General for the U.S. Department of Health and Human ServicesOIGOIG HHSSocial Security ActU.S. Department of Health and Human Services

False Claims Act Penalties Double with DOJ New Interim Rule

September 1, 2016Fraud & Abuse

Amanda Bogle Executive Editor Loyola University Chicago School of Law, JD 2017 On June 30, 2016, the Department of Justice joined other agencies in passing a new interim final rule, significantly increasing the penalties for the False Claims Act (FCA). Before, FCA penalties ranged from $5,500 up to $11,000 per false claim. The new …
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