WGA InsureBlog

The Centers for Medicare and Medicaid Services (CMS) released guidance back in December regarding the implementation of the Federal Sunshine Law and the proposed timing. Since then, the timeline for formal introduction of the law has been revised by CMS, delaying how soon those manufacturers must begin to collect data for their reports. Rather than requiring the collections to begin on January 1st, CMS will not require them to begin until the issuance of the law’s final ruling.

This law will require manufacturers of drugs, biologics, devices and medical supplies covered under Medicare, Medicaid and the Children’s Health Insurance Program to report payments and other transfers of value made to physicians Read more…

In an era of budget deficits and difficult economic times for health care providers, the call to eliminate fraud and abuse is constant. So much so that it sometimes seems loose its real meaning. Over the past year, the Centers for Medicare and Medicaid Services (CMS) has started using their latest tool in their ongoing fight against fraud and abuse, the ZPIC audit.

The audit program, called the Zone Program Integrity Contractors Audit, is armed with much more data and has a greater focus than audits that many providers are used to seeing from CMS. Published reports have indicated that these ZPIC audits “can be the most concerning”, according to Mark Higley, vice president of development for VGM Group, Waterloo, Iowa. Read more…