Health Law Matters

OIG Updates Provider Self-Disclosure Settlements

The Week In Health Law

  • The Office of Inspector General (“OIG”) under the U.S. Department of Health and Human Services (“HHS”) has updated its list of settlements with providers who self-disclosed various violations of fraud and abuse laws, to include the second quarter of 2019.
  • The employment of persons who have been excluded from participation in Federally funded health care programs continues to be a leading cause of self-disclosures and settlements. In the second quarter, the OIG settled a number of such cases, with settlements amounts ranging from $16,500 all the way up to $150,000.
  • There were also several cases involving improper billing for “incident-to” services, as well as cases involving kickbacks, excessive physician compensation, and the billing of improper and false claims.  Perhaps not surprisingly, these latter kinds of settlements tended to involve rather significant amounts, with one of them topping the $3 million mark.
  • In one interesting case, a home health agency paid $50,000 to settle a case where the provider submitted claims to Medicare and state Medicaid programs which apparently were for valid services; however, the provider indicated on the claims was not the one who actually rendered care to patients.

More trending Health Law topics this week:

  • Florida Repeals Certificate of Need Laws for New Hospitals

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Thomas D. Anthony is the former chair of FBT's Health Care Industry Team. He focuses on counseling health care entities on corporate transactions, regulatory compliance and joint ventures.