DOJ and HHS Release Health Care Fraud and Abuse Control Program Annual Report

On February 26, the U.S. Departments of Justice (DOJ) and Health and Human Services (HHS) released the Health Care Fraud and Abuse Control Program Annual Report for Fiscal Year 2015 (Report). The Report summarizes the fiscal year (FY) 2015 activities and results of the Health Care Fraud and Abuse Control Program (Program), which operates under the joint direction of both departments.

In its nineteenth year of operation, the government won or negotiated over $1.9 billion in health care fraud judgments and settlements, which, together with the efforts of preceding years, netted approximately $2.4 billion during FY 2015. Of the $2.4 billion, approximately $1.6 billion was returned to the Medicare Trust Funds, approximately $386 million was paid to federal agencies for restitution/compensatory damages, and approximately $414.5 million was paid to relators.

With respect to Program funding, after sequestration, the Program received approximately $380 million more in funding in FY 2015 as compared to FY 2014. For every $1.00 spent, the return on investment, calculated on a three-year basis through FY 2015, was determined to be $6.10 (down from $7.70 in FY 2014).Continue reading

What is FIPA and How Is FIPA Different From HIPAA?

By: Jackie Bain

FIPA is the Florida Information Protection Act of 2014.  It became elective on July 1, 2014.  Many people consider FIPA to be Florida’s state law counterpart to the Federal Government’s Health Information Protection and Administration Act of 1996 (“HIPAA).  However, FIPA is, in many respects, more far reaching than HIPAA.  Those who transact business in the State of Florida are well-served to be knowledgeable about FIPA.

FIPA affects more than just health care providers and those in the healthcare industry.  Under FIPA, any business that acquires, stores, maintains or uses personal information must take reasonable measures to safeguard that information.  “Personal information” includes the use of a person’s first and last name (or first initial and last name) in conjunction with his or her social security number, driver’s license or other government identification number, bank account number, credit or debit card number and password or pin, medical history, or health insurance policy number.  A convenience store that might have access to a person’s name and credit card number is just as accountable under FIPA as a hospital who might store that person’s medical history and insurance information.Continue reading