Apr 16, 2025 | Medicare and Medicaid
Donald Trump signed an executive order on Tuesday directing the Department of Health and Human Services to work with Congress on amending a key component of Medicare’s new drug price negotiation authority. The directive specifically targets a timeline that drugmakers...
Apr 14, 2025 | False Claims Act, Fraud Investigations, Government Investigations, Health Care, Health Care Fraud, Medicare and Medicaid
On April 4, 2025, the Department of Justice announced that it had filed a lawsuit under the federal False Claims Act against Vohra Wound Physicians Management and its founder, Dr. Ameet Vohra. According to the DOJ, Dr. Vohra and his company allegedly submitted false...
Mar 24, 2025 | Administrative Law, Health Care, Medicare and Medicaid, Overpayment Appeals
Because Medicare processes over one billion fee-for-service claims annually, it is impossible for CMS and its contractors to review every claim – or even a substantial percentage of claims – on a pre-payment basis. Accordingly, Medicare has set up various...
Mar 18, 2025 | Healthcare Transactions, Medicare and Medicaid
On March 14, Dr. Mehmet Oz, President Donald Trump’s nominee for the Centers for Medicare and Medicaid Services (CMS) Administrator, appeared before the Senate Finance Committee for his confirmation hearing. During the two-and-a-half-hour session, Dr. Oz navigated a...
Mar 4, 2025 | Medicare and Medicaid
A federal jury in Detroit convicted Sherif Khalil, a 50-year-old man from Redondo Beach, California, for his involvement in a fraud scheme that put Medicare out of over $4 million. The fraud stemmed from the submission of false claims for medically unnecessary urine...
Feb 20, 2025 | DMEPOS, Government Investigations, Health Care, Health Care Fraud, Medicare and Medicaid
If you are a DMEPOS supplier and are purchasing opt-in Medicare leads, you should be aware of Medicare’s prohibition against telephone solicitation of beneficiaries. In order to enroll as a Medicare DMEPOS supplier, and as a condition of payment, DMEPOS providers must...
