Physician Certification of Home Health Patients For Remuneration Found to be “Referral” and Violation of Anti-Kickback Statute

On February 10, 2015, in the case of United States v. Patel, the Seventh Circuit Court of Appeals affirmed the judgment of the District Court which found Dr. Kamal Patel, an internal medicine specialist, guilty of violating the Anti-Kickback Statute.  The case resulted from a federal investigation which revealed that Dr. Patel had received payments from Grand Home Health Care (“Grand”) for certifying and recertifying home care patients’ plans of care. Dr. Patel’s argument on appeal was that the certification… Read More >

CMS Announces Webinar on Comparative Billing Reports for Modifiers 24 & 25 for Specialty Surgeons

CMS recently announced that contractor eGlobalTech and its partner, Palmetto GBA, will present a webinar on Wednesday, March 4, 2015 from 3:00 – 4:30 pm ET addressing the comparative billing reports issued on modifiers 24 & 25 as applied to specialty surgeons (CBR201502). Comparative billing reports (CBRs) are intended to be tools to help providers gain a better understanding of the applicable Medicare billing rules. eGlobalTech describes CBR201502 as an educational tool to assist specialty surgeons (which excludes general and… Read More >

CMS Announces Extension of Temporary Moratoria on Enrollment of New Home Health Agencies and Part B Ambulance Suppliers in Six States

In the January 29, 2015 Federal Register, CMS announced a six-month extension of the temporary moratoria on the enrollment of new home health agencies (HHAs), HHA sub-units, and Medicare Part B ambulance suppliers in designated geographic areas in Florida, Illinois, Michigan, Texas, Pennsylvania and New Jersey. The CMS notice indicates that the decision to extend the moratoria was based on CMS’s determination of “a high risk of fraud, waste, or abuse in these provider and supplier types within these geographic… Read More >

Medical Record Disposal: Handle With Care to Avoid HIPAA Violations

Multiple news outlets recently reported on a case involving the dumping of patient dental records in a church dumpster in Indiana.  The records originated from a dentist who had lost his dental license due to fraudulent billing. The Indiana Attorney General’s office brought a case against the dentist for violation of HIPAA and state laws.  The dentist agreed to a consent judgment requiring payment of a $12,000 fine. Upon review of the information on the Indiana Attorney General’s website, it… Read More >