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New CMS Rule: Program Integrity Enhancements to the Provider Enrollment Process

The Centers for Medicare & Medicaid Services (CMS) recently announced a final rule entitled "Program Integrity Enhancements to the Provider Enrollment Process." The new rule, which will go into effect on November 4, 2019, requires Medicare, Medicaid, and Children's Health Insurance Program (CHIP) providers and suppliers to disclose any current or previous direct or indirect "affiliations" (as specifically defined by CMS) with another provider or supplier that: has uncollected debt...

Dental Practice Agrees to $10,000 Settlement for Potential Social Media HIPAA Violation

Last week, the Office for Civil Rights (OCR) announced a settlement related to allegations that a dental practice disclosed protected health information on its Yelp review page. The original complaint, filed in 2016, alleged that the practice impermissibly disclosed a patient's last name, details of her treatment plan, insurance, and cost information when responding to the patient's negative review. An OCR investigation revealed that this was not the only instance...

DOJ Targets Laboratory Owner in Nationwide Telehealth Fraud Scheme

Federal prosecutors in Florida and Louisiana have filed multiple indictments related to a nationwide telemedicine fraud scheme involving genetic testing. The arrangement included at least 35 individuals and has resulted in the submission of more than $2.1 billion of fraudulent claims. Earlier this week, federal prosecutors for the United States Department of Justice charged the CEO of LabSolutions, LLC, the owners of telemedicine companies Lotus Health, LLC, MedSymphony, LLC, and...

Medi-Cal Expands Provider Reach Through Revised Telehealth Policy

The California Department of Health Care Services recently revised its Medi-Cal Provider Manual (the "Manual") to permit additional flexibility for providers who wish to render health care services through telehealth. Medi-Cal defines telehealth as: "The mode of delivering health care services and public health via information and communication technologies to facilitate the diagnosis, consultation, treatment, education, care management and self-management of a patient's health care while the patient is at...

Telemedicine Company CEO and NJ Doctor Plead Guilty to Healthcare Fraud Scheme

Earlier this year, the U.S. Department of Justice (DOJ) indicted 24 telemedicine and medical equipment company executives and physicians for their involvement in an alleged $1.2 billion global healthcare fraud scheme after an investigation by the FBI, OIG, and IRS. Lester Stockett, owner of Video Doctor USA and CEO of AffordADoc, pleaded guilty to conspiracy to defraud the United States, paying and receiving kickbacks, and money laundering. Joseph DeCorso, a...