Medicare Revocation Reason #4 of 14 – Providing False or Misleading Information on Application
This could lead to Revocation PLUS fines or imprisonment or both
Medicare Revocation Reason #3 of 14 – can be triggered by a Felony conviction in last 10 years
Medicare Revocation Reason #3 of 14 – can be triggered by a Felony conviction in last 10 years
CMS is doing a sweep of its records on this issue after the relevant reg was changed to permit revocation for ANY felony conviction, not just those listed in the reg
Provider’s who may have disclosed a felony years ago and who were approved by CMS are now receiving revocation letters in this regard.
CMS is supposed to review each case and determine whether the a felony is detrimental to the Medicare program or its beneficiaries
HOWEVER
In reality, they usually do not document any reasoning in the revocation letter, so it is hard to determine if any analysis re the detrimental effect was undertaken at all.
This is a big issue and we should note that each revocation letter requires requires an individual assessment of the case facts to determine detriment.
Sometime the revocation letter is simply wrong about the conviction, and does not show any individual assessment. This can be reversed without filing a cap or reconsideration request by merely POLITELY . pointing out to CMS this was ludicrous and totally unfair.
REMEMBER
Keep your nose clean and felonies will never be an issue
Do not simply cop out and take a felony plea deal simply because it’s easier and cheaper
Understand the implications of a felony plea agreement BEFORE yo pleased to one
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If you have any questions, please feel free to give us a call today. We would be more than happy to assist you in these as well as other compliance-related matters.
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Mr. Laher is an attorney in private practice with Liles Parker, PLLC. We counsel and defend Health Care Providers nationwide on Health Law related issues such as Medicare Audits & Fraud Defense, Medicare Prepayment and Over Payment issues, CMS Suspension and Revocation Actions, Practice Specific Gap Analysis, Compliance Plans, Hippa & Osha mandatory training, and with General Counsel and Compliance Officer Services.
Much of the above was originally prepared/presented by the acknowledged source or by one or more Liles Parker attorneys for use in one or more of the many webinars, presentations, discussions with clients and and subsequently re purposed for use here by ISH (Attorney Ismail Laher)
Attorneys include Jennifer Papapanagiotou, Michael Cook, Robert Liles, David Parker, Andy Lynch, Paul Weidenfeld, Adam Bird, Lorraine Ater, Les Johnson, Jason Cabell, Leornad Schneider, Richard Pecore, Bethany Meuret, Heidi Kocher, Gloria Frank, Harri Williams, Ismail Laher