March 24, 2023
CMS issued notice on March 24, 2023 to Medicare Advantage Organizations, Part D Plan Sponsors, and Medicare-Medicaid Plans that the temporary enforcement discretion policy would end when the PHE ends on May 11, 2023. This means the flexibilities these organizations implemented during the COVID-19 PHE will end and they will need to follow current statutory and regulatory requirements.
March 21, 2023
HealthExec’s March 20, 2023 article listed the top 10 best & worst states for physicians. This ranking was based on research conducted by WalletHub who compare the 50 states and the District of Columbia across 19 key metrics, including salary, number of hospitals in the per capita area, and quality.
March 17, 2023
Former Naval officer, Jordan Thomas Broome, has been sentenced to 66 months in prison for submitting fraudulent Durable Medical Equipment (DME) claims of over $2.15M. Aided by other bad actors (providers who would “robo-sign” prescriptions for DME equipment for patients never seen), Broome illegally obtained over 2,000 Medicare beneficiaries’ personal information and mailed them DME equipment which they never asked for, nor needed. Read the full Press Release.
March 14, 2023
The Supreme Court of the United States (SCOTUS) denied Pfizer’s petition to review the Second Circuit’s Court of Appeals ruling that found Pfizer in violation of the anti-kickback statute. Two of Pfizer’s cardiac medications have a patient out-of-pocket cost of more than $1,000 per month.
March o2, 2023 With the Public Health Emergency (PHE) expiring on May 11, 2023, CMS updated their CMS PHE Fact Sheet on February 27, 2023. This fact sheet covers the following: COVID-19 vaccines, testing, and treatments; Telehealth services; Health Care Access: Continuing flexibilities for health care professionals; and Inpatient Hospital Care at Home: Expanded hospital […]
March 02, 2023
As mentioned in a previous article, an individual or entity can be excluded from participating in Federal health care programs for a variety of reasons. The individual/entity will receive notification from the OIG indicating the period of time for which they are going to be excluded.
03/01/23
James Luketich, MD and associated entities have agreed to pay $8.5M and initiate a Corrective Action Plan to settle False Claims allegations that Dr. Luketich “regularly performed as many as three, complex surgical procedures at the same time, failed to participate in all of the “key and critical” portions of his surgeries, and forced his patients to endure hours of medically unnecessary anesthesia time, as he moved between operating rooms and attended to other patients or matters.”
