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I was listening to my favorite morning radio show recently and the discussion turned to people’s favorite all-time television shows. Being from Massachusetts and listening to a local radio program, one of the shows that came up, as expected, was Cheers. Talking about Cheers of course led me to think about its theme song, Where Everybody Knows Your Name.
The Centers for Medicare & Medicaid Services (“CMS”) has implemented a recent enforcement trend under which it is seeking to terminate the provider agreements of hospitals with low inpatient volumes as compared to outpatient volumes.
A recent decision by the Department of Health and Human Services (“HHS”) Office of Medicare Hearing and Appeals (“OMHA”) to stop assigning provider appeals to administrative law judges (“ALJs”) is having a significant impact on provider Medicare reimbursement revenue. The decision is contrary to the plain text of the controlling Medicare statute, and OMHA has not provided any legitimate justification for this departure from controlling law.
The Department of Health and Human Services’ Office of Inspector General (“OIG”) 2014 Work Plan has a new provision that has generated a fair amount of press lately: The proposal to review how executive pay falls within a hospital's operating costs. The review could result in the imposition of caps on the amount of executive compensation that can be included in the hospital's cost report.
On January 31, 2014, the Office of the Inspector General (“OIG”) of the Department of Health and Human Services (“HHS”) released its annual Work Plan. The Work Plan describes ongoing and new projects that the OIG intends to conduct during the coming year.
The Department of Justice (“DOJ”) trumpeted 2013 as another “banner year” for litigation filings and recoveries under the False Claims Act (“FCA”). The DOJ reported a 15 percent increase over the number of qui tam cases filed in 2012, the previous record-holding year, and $3.8 billion in fraud settlements and judgments, the second largest annual total.