Minnesota Gov. Tim Walz has appointed Judge Tim O'Malley as the director of program integrity, a new fraud watchdog role intended to tackle widespread abuse in taxpayer-funded programs. The goal of the position is to enhance fraud prevention across state agencies, including Medicaid programs. O'Malley has an extensive law enforcement and legal background, including roles with the FBI and the state Bureau of Criminal Apprehension.

Recovery Centers of America will pay $2 million to settle allegations that it violated the Controlled Substances Act and the False Claims Act. Audits and investigations by the Drug Enforcement Administration found that the Pennsylvania-based organization mishandled controlled substances, and the government alleges RCA billed the Federal Employees Health Benefits Program and Medicaid for treatment services that were not provided.

LifeWorks Counseling Associates and owner Dr. David Ferruolo have agreed to pay $300,000 to settle allegations that they violated the False Claims Act by submitting claims to Medicaid for services provided by a person excluded from the program. LifeWorks is a New Hampshire-based telehealth mental health provider.

The Department of Veterans Affairs is implementing a "cyber dominance" strategy to enhance protection of veterans' data, moving from a compliance-based to a risk-based approach to cybersecurity, says VA acting CIO Eddie Pool. The strategy includes zero trust architecture and network microsegmentation. Pool says the VA aims to be a leader in cybersecurity within the federal government. "We do have some great things coming down the pipe in terms of how we're going to modernize this across the board," Pool said.

Neither a bill put forth by Republicans to replace enhanced Affordable Care Act subsidies nor one sponsored by Democrats to extend them garnered enough votes in the Senate to break a filibuster. House Republicans want to vote on an ACA subsidies bill next week, but no vote has been scheduled, nor have they agreed on a bill to advance.

Retrospective chart reviews by Medicare Advantage insurers led to additional diagnosis codes for 17% of subscribers that were not reflected in other medical records, according to a Kaiser Family Foundation analysis. Chart reviews resulted in the removal of diagnosis codes for only 1% of subscribers, researchers found. Chart review practices vary significantly among insurers and have drawn scrutiny from the Justice Department, which is pursuing legal action against some insurers for allegedly using chart reviews to inflate risk scores.

NHCAA Partner Webinars, available only to NHCAA Member Organizations, provide an opportunity to showcase your anti-fraud expertise through live training hosted on your preferred webinar platform. Partners receive and manage all registration data. NHCAA provides promotion for your webinar with two targeted emails and a spotlight on our website. For more information or to schedule a Partner Webinar, visit the Sponsorship Opportunities page on the NHCAA website or contact us at programs@nhcaa.org with any questions or ideas.

NHCAA's Platinum and Premier Supporting Members are leading providers of products and services to the health care anti-fraud industry, are valued partners who support NHCAA's mission, and have demonstrated outstanding commitment to the fight against health care fraud. Learn more about these companies on the Fraud Solutions Directory.