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Volume 22.05

The Department of Health and Human Services and the Department of Justice have released the Health Care Fraud and Abuse Control Program Annual Report for Fiscal Year 2021

During FY 2021, the federal government won or negotiated more than $5 billion in health care fraud judgments and settlements.

The Report provides highlights of significant criminal and civil investigations by type including:

  • Ambulance transportation services
  • Clinics
  • Diagnostic testing
  • Drug companies
  • Durable medical equipment
  • Electronic health records
  • Genetic testing
  • Home health providers
  • Hospice care
  • Hospitals and health systems
  • Laboratory testing
  • Managed care
  • Medical devices
  • Nursing homes and facilities
  • Pharmacies
  • Physical therapy
  • Physicians and other practitioners
  • Prescription drugs and opioids
  • Psychiatric and psychological testing and services
  • Substance use treatment centers

The Report provides an all-inclusive look into the current and potential activities relating to the identification and pursuit of fraudulent and abusive activities, including Medicare provider screening.  All providers should be continuously aware of areas of focus as described in the Report.  The entire Report is available at FY 2021 HCFAC Report (hhs.gov).


The Medicare Payment Advisory Commission (“MedPAC”) has released the June 2022 Report to Congress, Medicare and the Health Care Delivery System.  The Report includes seven (7) chapters devoted to:

  • Ways to streamline and harmonize Medicare’s portfolio of alternative payment models,
  • Vulnerable Medicare beneficiaries’ access to care,
  • A framework for identifying safety-net providers,
  • Addressing the high prices of drugs covered by Medicare Part B,
  • Improving the accuracy of Medicare Advantage payments,
  • Aligning fee-for-service payment rates across ambulatory settings, and
  • Segmentation in the stand-alone Part D prescription drug plan market.

The entire Report is available here.


Registrations are currently being accepted for the 2022 Hospice Financial Management Academy scheduled for September 19-20, 2022, at the Hotel Monteleone, New Orleans.  Preliminary program information, including registration and discounted hotel rooms, is available here.  Space is limited and early registration is encouraged.