The Committee is requesting actors in the health care sector to
submit "white papers" in PDF or Microsoft Word format
that address potential improvements in the following
Program Integrity Reforms to Protect Beneficiaries and Prevent
Fraud and Abuse
Payment Integrity Reforms to Ensure Accuracy, Efficiency and
Fraud and Abuse Enforcement Reforms to Ensure Tougher Penalties
Against Those Who Commit Fraud
The white papers should be submitted via email by June 29th to
The Committee members plan to have their staff review the white
papers and then compile a summary document highlighting key
proposals later in 2012.
This letter is the most recent instance where the government has
sought the expertise of the private sector in addressing fraud,
waste, and abuse. Another example came to light in February 2012,
when HHS-OIG issued its report related to the Pharmacy Compliance
Roundtable, where it convened compliance professionals in the
pharmaceutical industry. There, the private sector players
discussed their experiences with Corporate Integrity Agreements
(CIAs) and other compliance efforts initiated by the government
with HHS-OIG representatives. Prevention is becoming the new focus
of fraud-fighting efforts, and the government needs private sector
cooperation to achieve its goals in this area.
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guide to the subject matter. Specialist advice should be sought
about your specific circumstances.
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While some may consider improper multiple dependent claims as failing to comply with a mere formality, this case serves as a reminder that a court may consider any statutory requirement when assessing patent validity.
Mintz, Levin, Cohn, Ferris, Glovsky and Popeo, P.C.
While at first pass the case focuses on a small set of insurance policies, this decision could have broader implications on the individual market and further threaten the sustainability of the risk pools.
The Centers for Medicare & Medicaid Services and the Office of Inspector General have reviewed the use of Modifier 25 to unbundle payments for evaluation and management services when a procedure is performed.
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