Martin Milita: Martin Milita: Protecting New Jersey’s Waterways f...

Martin Milita: Martin Milita: Protecting New Jersey’s Waterways f...: Martin Milita: Protecting New Jersey’s Waterways from Potential E... : Martin Milita is senior director with Duane Morris Government Strateg...

Martin Milita: “Is Congress an endangering species?” a review of ...

Martin Milita: “Is Congress an endangering species?” a review of ...: “Is Congress an endangering species?” a review of an article by Duane Morris Government Strategies Senior Director, Martin Milita | Cyber Tr...

Martin Milita: Protecting New Jersey’s Waterways from Potential E...

Martin Milita: Protecting New Jersey’s Waterways from Potential E...: Martin Milita is senior director with Duane Morris Government Strategies, a business consulting firm affiliated with the international law f...

Martin Milita: Companies that bid on public contracts may find it...

Martin Milita: Companies that bid on public contracts may find it...: Companies that bid on public contracts may find it necessary from time to time to challenge specifications, the responses submitted by oth...

What to expect from an Internal Company Investigation

Duane Morris Government Strategies, LLC
Image: dmgs.com

Attorney Martin Milita serves as senior director at Duane Morris Government Strategies, LLC, in Trenton, New Jersey. A member of the Business Law Section of the American Bar Association, Martin Milita draws on his skills and experience in business law to walk companies through the process of conducting an internal investigation.

A number of events can trigger an internal investigation within a company, including an allegation or suggestion of wrongdoing or misconduct. The allegation or suggestion may come from an outside source, such as a regulatory agency, or an internal party, such as an employee or shareholder.

Once a company deems an internal investigation necessary, the company should first locate and review any documents related to the inquiry. Then, it should conduct interviews with anyone who may be involved or have knowledge relevant to the investigation. Finally, the company should compile all findings and report to company leaders and to those responsible for triggering the investigation.

The process of an internal investigation can be complicated and time consuming, but companies can save time and stress by employing the services of an attorney experienced in business law.

“Is Congress an endangering species?” a review of an article by Duane Morris Government Strategies Senior Director, Martin Milita | Cyber Trusted Review

“Is Congress an endangering species?” a review of an article by Duane Morris Government Strategies Senior Director, Martin Milita | Cyber Trusted Review

Betting on Atlantic City – An Interview with Attorney Martin Milita, Esq., Senior Director with Duane Morris Government Strategies | Cyber Trusted Review

Betting on Atlantic City – An Interview with Attorney Martin Milita, Esq., Senior Director with Duane Morris Government Strategies | Cyber Trusted Review

“Is Congress an endangering species?” a review of an article by Duane Morris Government Strategies Senior Director, Martin Milita | howsecurity.org

“Is Congress an endangering species?” a review of an article by Duane Morris Government Strategies Senior Director, Martin Milita | howsecurity.org

“Is Congress an endangering species?” a review of an article by Duane Morris Government Strategies Senior Director, Martin Milita | howsecurity.org

“Is Congress an endangering species?” a review of an article by Duane Morris Government Strategies Senior Director, Martin Milita | howsecurity.org

About Martin Milita | howsecurity.org

About Martin Milita | howsecurity.org

The Way of the 21st Century: Going Nowhere While Very, Very Frightened | Casey Research

The Way of the 21st Century: Going Nowhere While Very, Very Frightened | Casey Research

Betting on Atlantic City – An Interview with Attorney Martin Milita, Esq., Senior Director with Duane Morris Government Strategies | howsecurity.org

Betting on Atlantic City – An Interview with Attorney Martin Milita, Esq., Senior Director with Duane Morris Government Strategies | howsecurity.org

Do this before you die… It will make all the difference to loved ones…

Do this before you die… It will make all the difference to your loved ones…

Failing to plan for your death can screw things up big time…

The New York Times reports the family of a deceased veteran almost had to put his corpse in cold storage for six months. They couldn’t bury him in Arlington National Cemetery until they produced his DD 214 form (a certificate proving his honorable service with the military). The family had never even heard of a DD 214 before… By sheer chance, they found it as a bookmark in one of his books. Don’t let this situation happen to you. It may not be a fun task… but planning for your demise or that of your loved ones is critical. Keep in mind the following important points:

1. If you’ve made your own burial details, ensure you have shared these written plans with your family.

2. Establish a will or a “living trust.” If you own out of state real estate or a family business, a trust may be superior. Otherwise a will may be fine. Talk to a lawyer to decide what is best for your situation.

 

3. An unclear will may be worse than no will at all. You may give unintended parties a claim on your assets if you’re not careful and precise.

 

4. Establish a living will and/or durable power of attorney in someone you trust to make end-of-life decisions while you are incapacitated.

 

5. Grant financial power of attorney to someone you trust. In general, this person should be different from the person who has power of attorney in health-related issues.

 

6. Distribute all your directives to as many people as possible: your doctors, family members, lawyers, et al.

 

7. List your passwords/logins for everything of import.

 

8. Maintain tax records for the deceased for several years. Yes, the IRS does audit dead people…

 

9. Include a medical history for your posterity to know what genetic predispositions they may have.

 

10. List what companies (if any) auto-debit from your bank or credit card.

 

11. Explain all the ins and outs of your house: the alarm system, the sprinklers, etc.

 

12. This one is special: Think about writing letters to your loved ones to be read after your death. It can help ease their grief at your passing. 
Operating out of the Newark and Trenton, New Jersey, offices of the government and business consulting services company Duane Morris Government Strategies, Martin Milita serves as a senior director handling government affairs in New Jersey. Admitted to the bar in New Jersey, Martin Milita received a juris doctor from the James E. Beasley School of Law at Temple University. Martin works closely with the Duane Morris International Law firm on many issues. Martin Milita is a Life Member of the 24 th Infantry Association "First to Fight" and the New Jersey Naval Militia Foundation.

7 Challenges to writing an effective RFP proposal.

7 Challenges to writing an effective RFP proposal.

 

To write a proposal, you must meet seven demonstrable challenges. You cannot avoid them. You cannot skip any of them. You just have to face them.

 

1. Complying with the RFP. First you have to read it and understand it. Then you have to cross-reference all the requirements across the various sections. Even if your assignment is for a single section, there may be requirements in other sections that are relevant, especially the evaluation criteria. Achieving RFP compliance is part using the customer’s terminology and keywords, part cross-referencing, and part understanding their evaluation process. Cross-referencing can be tricky and often requires interpretation.

2. Writing is easy. Figuring out what to write about is harder. If you want to win, it’s important to avoid the temptation of starting from another proposal. Once you know what should go into the proposal, writing it is pretty straightforward. What we do is follow a process that quickly guides people through considering everything that should go into a proposal and sets them up with a plan for writing it.

3. Articulation.  Some people get stuck in the mechanics of putting the words together. They are not sure how it’s supposed to sound. We pay attention to style. But we pay more attention to whether it is simply descriptive or whether it says something that matters from the customer’s point of view. The most important thing to accomplish in proposal writing is to make it reflect the customer’s point of view. What the customer sees on the paper should provide answers to their questions, complete their evaluation process, and practically impel the conclusion that you are the best alternative. You have goals to accomplish, terminology from the RFP to use, and have to put it in the reader’s perspective instead of your own. That can be difficult, especially for people new to proposal writing. But when we review proposals, we often see problems in proposals written by people with many years of experience as well. We provide lots of guidance on every aspect of proposal writing to help people find their voice.

4. Figuring out what to offer. Whatever you do, don’t figure out what to offer by writing about it. This is a recipe for proposal disaster. Figuring out what to offer and figuring out what to write about should be done in parallel. Only after they have both been figured out and reviewed to ensure they aren’t likely to change should you start writing. Figuring out what to offer by writing about it does incredible damage to proposals. We have seen it cost companies hundreds of millions of dollars.

5. Articulating your bid strategies. The truth is the bid strategies for the proposal should be figured out before the writers ever get their assignments. Bid strategies should be just one of the ingredients that go into what you need to write. You must figure out the bid strategies before you start writing or designing your offering. The proposal should prove the bid strategies.

6. Passing the review. Most companies review their proposals before they finish them. Most companies do a poor job of conducting these reviews. The instructions to writers should reflect the same quality criteria that the reviewers will use. If you use a process to figure out what to write, then the plan it produces can also be used to increase the effectiveness of the review process. If writers are at the mercy of a completely unpredictable and subjective review process, the only way good can come from it is by luck.

7. Winning. If you start focusing on winning your proposals when the writing starts, you are too late. The pre-RFP stage is critical and driven by relationships with key decision makers, influencers, stake-holders and allies. You need to know them. We manage the pre-RFP stage like election campaigns. Know the answers to important questions and know your competition you’re your competitions strengths and weakness. The pre-RFP stage is when you really should be focused on winning. When you focus pre-RFP , you will realize that in order to incorporate what it will take to win into your plans for the proposal, you’ll need answers to questions that should have been asked before the RFP even came out.

 

 

 

Thoughts on police body Cameras?

Thoughts on police body Cameras?

For many communities, public safety is a major concern—especially as budgets are cut and populations continue to grow. Placing small cameras on police is a fast-growing trend in policing. The cameras -- which are small enough to fit on a vest, an officer’s collar or on eyewear may be an important tool to porducing tangible evidence of criminality; to altering the public’s behavior (as speed camera’s reduce inattentive driving  in school and construction zones) and enhancing police accountability. Many police departments have some or all of their officers wearing body cameras, including Atlantic City, N.J.; Ferguson, Mo. (as of last week); Los Angeles (one of the nation's largest police departments); Oakland, Calif.; Phoenix; San Diego and Seattle.

Using video to record police interactions is not new. In the past decade, police departments have installed more than 17,500 cameras in police cars, according to the International Association of Police Chiefs (IACP). The initial reason for the dashboard cameras was to improve officer safety and mitigate allegations of racial profiling. But police departments also discovered the cameras provide substantive evidence and improved officer conduct.

But body cameras, like safe zone speed and right light cameras have their critics.

Libertarians see privacy concerns when police venture inside someone’s home and other private areas. In addition, situations involving children and victims of domestic abuse must be treated sensitively. Recently, the American Civil Liberties Union issued a report in support of body cameras but called for measures to ensure police officers do nothing to edit the recordings and for stricter limits on officers' ability to choose when to use the camera.

Questions have arisen about the reliability of the technology and the costs (an entire system with cameras, storage and software can run from several hundred thousand dollars into the millions of dollars, according to some estimates). When an officer comes in from a shift, he or she attaches the device to a docking station, which automatically downloads the recording to a third-party storage facility.

Cameras-body, speed and intersection- are coming into wide use by towns, cities public agencies and law enforcement. Government departments that try to use new technology like body cameras before they have promulgated policies about use, and privacy and chain of evidential custody, invite trouble.  Many manufacturers and distributors of cameras like Xerox have drafted model guidance’s  for these nescient technologies -including wearable cameras.

Martin Milita is a senior director of Duane Morris Government Strategies. Duane Morris Government Strategies is an ancillary business of international law firm Duane Morris LLP, one of the 100 largest law firms (700+ attorneys) in the United States and abroad.  Martin Milita is retained by Xerox to represent the company before the New Jersey Legislative and Executive branch departments tackling all forms of government relations and public affairs. Martin Milita believes that every community deserves safe streets. That’s why he advocates installing, operating and maintaining customizable, automated, photo-enforcement solutions, including red light,  safe zone speed, school bus, and wearable cameras.

 

Companies that bid on public contracts may find it necessary from time to time to challenge specifications

Companies that bid on public contracts may find it necessary from time to time to challenge specifications, the responses submitted by other bidders, or the award of the contract itself.

However, bidding challenges are subject to definite time limitations, which are routinely enforced by courts. Thus, the key to success in public bidding disputes is twofold: the vendor must be able to quickly spot issues and irregularities that may give rise to a protest and must immediately take action in the correct venue to preserve the challenge.

Only by so doing, will a company that regularly bids on public work be able to fully protect its business interests and to maximize its revenue from government contracts. Specifications Issued in Connection with an RFP Typically, governmental units seek services from vendors through the issuance of a “Request for Proposals,” or “RFP,” which invites qualified companies to submit responses, or bids, for the services or products sought. In most cases, the RFPs provide a set of specifications that describes what the government is seeking to purchase, detail with specificity what features a particular product or service must have, and set forth the technical requirements that must be met.

Challenges to specifications generally concern whether the language employed is clear and understandable and whether the technical requirements are rationally and reasonably related to the goods and services sought. Other challenges concern whether the specifications are written to favor one bidder such that only that bidder, and no other, is capable of performance or whether the specifications are capable of performance by any vendor at all. A bidder should not submit a response to the RFP with the belief that any issues or concerns with the specifications can be raised later if in fact another vendor is awarded the contract.

 In New Jersey, all challenges to bid specifications must be brought prior to bid opening; otherwise, such challenges are forever lost. In other words, a disappointed bidder will not be heard to complain about specifications, as the law presumes that a bidder who responds to an RFP understood and was able to respond to the specifications.

Challenges to Specifications are typically brought within the governmental unit that issued the RFP. State agencies often have specific regulations governing the challenging of bid specifications. For example, the Purchase Bureau within the State Department of Treasury (which issues RFPs for a variety of state purchases) requires that protests of specifications be submitted in writing “in sufficient time to permit a review of the merits of the protest and to take action as may be necessary prior to the scheduled date and time of bid opening”. The State may disregard any protest not containing specific information required by the applicable regulations and also if the protest is “filed less than 72 hours before the scheduled bid opening.” Although a protest filed after the deadline may still be heard, experience teaches that such untimely challenges are routinely ignored, leaving the bidder without recourse.                

 Under the regulations promulgated by the Department of Treasury, a vendor that has submitted a response to an advertised RFP may submit a written protest challenging either the rejection of its bid or the award of the contract itself. Such challenges must be brought within “10 business days following the vendor’s receipt of written notification that its bid has not been accepted or of the award decision.” The Department has the discretion to disregard any protest filed after the 10-day period and to proceed with the award of the contract. The protest must specify the grounds for the challenge and attach all documents relevant to the claim, as well as include a statement as to whether an oral presentation is required. Generally, in cases where the lowest bid was not accepted, all bidders are notified of the award and the Department is obligated to wait 10 days before awarding the contract, so as to allow for the filing of protests. In cases where the award is challenged, the contract is not to be awarded until the protest is resolved — except where the failure to award shall result in substantial cost to the State or if public exigency so requires. In any case where such concerns exist, the Department can modify or amend any deadline in the regulations upon adequate notice to the parties involved. The Department has the sole discretion to allow oral presentations and can request by way of discovery from the protesting bidder any documents deemed relevant to the issues. The Department can also consider documents requested and received by other bidders. Unless oral testimony is received, the record on the case consists of the protest filed by the bidder; the RFP at issue; the bids submitted by the other vendors; the evaluation report; the award document; and relevant cases, regulations, and documents. A bidder dissatisfied with the outcome of the protest does not file a case with the trial court but, rather, with the state intermediate appellate court, which can decide the case or take other action as it deems appropriate.

Martin Milita, is in the  public affairs solutions industry, serving Duane Morris Government Strategies, LLC, in Trenton, New Jersey, as senior director. His responsibilities include providing important clients with strategic advice on matters ranging from business-to-government outreach to corporate development. Martin Milita has  successfully represented entities large and small, for profit and not for profit on billions of dollars of public procurements- including the Xerox Electronic Tolls Collection contract in New Jersey Before establishing himself as a lobbyist, Martin Milita enrolled at the Temple University James E. Beasley School of Law, from which he graduated cum laude with his juris doctor. Prior to that, he earned his bachelor of arts in political science from King’s College. Early in his career, Martin Milita served as New Jersey state deputy attorney general in the Department of Law and Public Safety. In that role, he successfully resolved enforcement issues related to tax and Medicaid fraud. After two decades practicing law, Mr. Milita co-founded Holman Public Affairs. There he built relationships with Fortune 500 businesses in need of assistance regarding legislative and executive branch strategies at the state and federal levels. Beyond his professional duties, Milita supports a number of nonprofit groups, including the Civil War Trust and the Knights of Columbus, the 24th Infantry Association (First to Fight), and the New Jersey Naval Militia Foundation.

The Top 10 Areas for Medicaid Compliance Focus

Medicaid enforcement is a hot topic in Health and Human Services and the U.S. Department of Justice as they jointly issued Health Care Fraud and Abuse Control ("HCFAC") program annual report.
 
According to the HCFAC report, HHS-OIG investigations resulted in 849 criminal actions against individuals or entities that engaged in crimes related to Medicare and Medicaid. HHS-OIG also excluded 3,214 entities, 1,132 of which were due to convictions for crimes related to Medicare and Medicaid. This robust enforcement is despite the fact that the DOJ and HHS had $30.6 million sequestered from the HCFAC program in FY 2013. In FY 2013, the federal government won or negotiated approximately $4.33 billion in judgments and settlements, resulting in $576 million in federal medicaid money being transferred to the treasury.

 The Top 10 Areas for Medicaid Compliance Focus

The Affordable Care Act provided several additional tools to assist the government which have changed the landscape for enforcement and increased the risks providers and suppliers face. These new federal laws overlay state laws and rules which vary, sometimes widely, by state.

 It can sometimes seem difficult to design an effective Medicaid compliance program given the many potential sources for compliance requirements and many recent changes. Below we suggest 10 areas which can be a start in addressing efforts at Medicaid compliance.

 DRA Compliance

Effective since Jan. 1, 2013, any entity which receives at least $5 million annually from a Medicaid state plan must establish written policies for all employees that provide detailed information about the False Claims Act and state laws pertaining to civil penalties for false claims and statements, whistleblower protection laws and the role of these laws in preventing and detecting fraud, waste and abuse in federal health care programs.
Some states require that providers and suppliers complete and submit “Certification of Compliance with the Federal Deficit Reduction Act of 2005” forms that must be filed with the state to ensure compliance with the Deficit Reduction Act ("DRA").

In addition to assuring that necessary policies are in place, providers and suppliers should also be prepared to deal with a labor force that is more sophisticated about its opportunities for whistleblowing.

Provider Enrollment

For providers and suppliers, the enrollment process must be viewed as a high-priority, and compilation of supporting documents and the completion of lengthy enrollment forms, while more than somewhat tedious, must be assigned to competent personnel under high-level supervision. These enrollments are currently done separately by each state despite some earlier commentary from CMS about hopes to consolidate Medicare and Medicaid enrollment activities.

ACA Section 6401 required Medicaid state plans to enhance the scrutiny required for prospective provider and supplier program enrollments.

 •States must perform screenings of potential providers and suppliers. In certain circumstances, states must require criminal background checks and fingerprint scans.

•States are required to revalidate enrollments at least every five years.

•States must conduct site visits (pre- and post-enrollment) for providers who are in the designated categories of high or moderate risk, and must require providers to agree that CMS, the state and other entities may conduct unannounced site visits at any time at any and all provider locations.

•States must deny or terminate the enrollment of any provider that is terminated on or after Jan. 1, 2011, under Title XVIII of Medicare, under the Medicaid program or Children's Health Insurance Program ("CHIP") of any other state. This means that a sanction by another Medicaid program, such as an enrollment revocation or termination for cause, can have a reciprocal effect across all other Medicaid enrollments.

Moratoria on New Enrollments

Companies seeking to expand to new locations or lines of business should check at an early stage for any federal or state moratoria that may preclude or delay such a strategy. Under provisions added by the ACA, a state may impose temporary moratoria to preclude the enrollment of new providers or impose numerical caps or other limits on such enrollments.
For example, in October 2013, California’s Medi-Cal program imposed a temporary moratorium on the enrollment of clinical laboratories or the change or expansion of provider-of-service categories for an already existing laboratory, subject to certain exemptions.

 Application of Stark Law to Medicaid

The federal Stark Law prohibits Medicare payments for claims reflecting physician self-referrals for certain designated health services, a relatively simple concept which has been made exceedingly complex by federal regulations. Federal law further provides that federal Medicaid payments, called federal financial participation ("FFP"), should not be paid to a state for services which would be in violation of the Stark Law if payment were sought under Medicare.
Some recent court cases have reflected allegations that a provider can violate the federal False Claims Act by submitting Medicaid claims that would violate the Stark Law if submitted under Medicare and then falsely certify Medicaid compliance with the knowledge that the certification was false.

 While these theories continue to be challenged, providers should consider this as a potential business risk when structuring arrangements involving physicians. State law with similar provisions may also be applicable, some of which may also apply for commercial payers in addition to Medicaid.

Payment Suspensions Based Upon Credible Allegations of Fraud

For any entity under investigation, the possibility of an immediate cash flow crisis resulting from a payment suspension must be considered. Note that some Medicaid programs require a self-report to the Medicaid agency if a provider discovers it is under investigation.
Section 6402(h) of the ACA, amended by 42 U.S.C. Section 1396b(i)(2), provides payments to a provider or supplier that will be suspended pending investigation of credible allegations of fraud, and that there will be no FFP payments in such circumstances if payments are not suspended, unless the state determines there is good cause not to suspend the payments.

CMS has issued regulations applicable to Medicaid suspensions at 42 C.F.R. 455.23. "Credible allegation of fraud" is not defined in the statute, but is defined in 42 C.F.R. 455.2 to include allegations from such sources as fraud hotline complaints, data-mining claims and patterns identified through provider audits, civil false claims cases and law enforcement investigations. Although payment suspensions are temporary, no maximum period of Medicaid payment suspension is set by these federal regulations, in contrast to similar provisions applicable to Medicare payment suspensions.

In its recent FY 2013 MFCU Report, OIG-HHS noted that the Medicaid payment suspension rules put in place by the ACA have not been fully implemented by the states. State agencies have expressed difficulty with determining what constitutes a credible allegation of fraud, with the ability to make determinations in a timely manner and with what should be the standard for a “good cause” exception.

HHS-OIG indicates that it has undertaken additional reviews regarding these payment suspensions. Providers and suppliers should expect states to become more aggressive in their imposition of suspensions based on credible allegations of fraud in the near future once the noted challenges are addressed.

State Specific Provisions

Because each state’s Medicaid program is operated by the state — subject to certain parameters imposed by CMS — each state will have its own set of fraud, waste and abuse provisions which its providers and suppliers must comply with. These requirements are commonly found in statutes, regulations and provider manuals issued by the state, and often require a working understanding of state-specific peculiarities to navigate through their maze-like structure.

In some states, there may be other sources that also set forth requirements for participation. For example, in California, the Medi-Cal Provider Agreement, a document signed by the provider as a condition for participation, or continued participation, in Medi-Cal (i.e., California’s Medicaid program), sets forth the provider’s agreement to 41 different provisions.

These include acknowledgment that the provider is subject to several different types of payment suspensions; the provider’s express agreement to make available its records for inspection by the state agency, attorney general and the Secretary of HHS; and the acceptance of various time limits for submission of updates to its enrollment information.

The compliance challenge for providers and suppliers is to identify where to find the state requirements and how to keep up with them when they change.

 Excluded Provider Checks

In addition to the federal exclusion lists, exclusion or termination lists often exist at the state level. For example, in New York, if the Office of Medicaid Inspector General ("OMIG") finds good reason that a provider should no longer be eligible to participate, the provider is placed on a list of excluded providers. In California, Medi-Cal maintains a list of providers who are “ineligible and suspended.”
Those on a state list will not turn up on the federal list unless HHS-OIG has taken action to exclude them. Similarly, those who are terminated from Medicare participation by CMS will not show up on the HHS-OIG exclusion list.

Some states require that their lists be checked on a monthly basis. CMS and HHS-OIG have both recommended monthly checks of the HHS-OIG exclusion lists, but have not made that mandatory.

Medicaid RACs

Section 6411 of the ACA extended Medicare’s highly successful Recovery Audit Contractor ("RAC") program to the Medi-Cal program.

CMS required state agencies to enter into contracts with RACs to identify overpayments and underpayments. The RACs are paid on a contingent fee basis, just as Medicare RACs — now called “recovery auditors” — are paid.

In December 2011, CMS issued FAQs which further explained its expectations for state implementation, including that states were not required to include managed care claims in the RAC audits as of that time (only fee-for-service), but might revisit that limitation in the future.

 Providers should determine the identified areas for RAC review and review state-specific coverage and payment rules applicable to such items and services to assure their claims will be best-positioned so auditors will allow them.

60-Day Refund Rule

Effective with the ACA’s passage in 2010, Medicare and Medicaid providers, suppliers and plans are required to report and refund known overpayments no later then 60 days from the date the overpayment is identified or the date a corresponding cost report is due, if any. Failure to refund identified overpayments is grounds for imposition of federal civil monetary penalties and False Claims Act liability.

The FCA includes provisions which allow whistleblowers to share generously in the government’s recovery against a provider and, as discussed above, providers must maintain policies designed to educate their employees about the FCA to be compliant with the DRA.

Some states, such as New York, have provided comprehensive guidance as to how providers and suppliers should interpret these provisions and make necessary refunds.

Even in the absence of specific guidance from a state, however, the refund statute is in effect and providers and suppliers should establish policies for promptly identifying, disclosing and refunding any excess Medicaid payments.

Mandatory Compliance Plans

Prior to the ACA, adoption of compliance programs were largely voluntary even though the HHS-OIG strongly recommended the adoption of its compliance plan guidelines for several provider types.

The ACA transformed compliance plans into a requirement for “provider[s] of medical or other items or services or supplier within a particular industry sector or category” as a condition of enrollment in Medicare, Medicaid or CHIP.

HHS, in consultation with the OIG, was tasked with establishing core elements for the compliance plans for different industry sectors. These core elements include: (1) written policies and procedures, (2) compliance officer, compliance committee and high-level oversight, (3) effective training and education, (4) effective lines of communication, (5) well-publicized disciplinary standards, (6) effective system for routine monitoring and auditing and (7) prompt response to compliance issues.

While federal regulations have not yet been issued which provide further instructions, providers and suppliers should be prepared for these to be issued. State requirements should also be checked for compliance requirements. For example, in New York, the OMIG has already provided a “Compliance Program Review Assessment Form” and also has a form which permits a New York Medicaid provider to certify that its compliance program satisfactorily meets the requirements of pertinent state law.

Conclusion
As illustrated by the HHS-OIG and HCFAC reports, Medicaid enforcement is on the rise. The ACA introduced several new areas that create a need for providers to focus on Medicaid compliance efforts. Medicaid compliance will necessitate an understanding of both federal and state requirements.

 

FQHCs provide much needed care to the most impoverished citizens in states

Tracing their roots to the civil rights movement and the 1960s’ War on Poverty, federally qualified health centers play an important role in the U.S. health care system. In the State of New Jersey, the major providers of comprehensive community-based primary health care are the 20 community health centers and their satellite sites, federally funded/qualified by Sections 330/329 of the United States Public Health Service. The FQHCs provide much needed care to the most impoverished citizens in the state. Although somewhat different in composition and in the nature of services offered, the FQHCs all target the health care needs of the medically underserved within their respective service areas.

Approximately 1,300,000 patient visits are made annually to New Jersey's FQHCs by almost 422,000 users.  Community health centers provide comprehensive preventive and primary care and other clinical services—for example, laboratory testing, radiology, pharmacy, dental care, behavioral health and even medical specialty care in some cases—and services that assist with access to care, such as language translation and transportation.

The FQHC designation was created in 1991 by the feds for community health centers that rely on a mix of federal and state funding. They have grown over time and are on schedule to increase their services next  year, as the state continues adding  more than 200,000 new Medicaid recipients.

Governor Christie has said that he shifted funding from family-planning clinics to the FQHCs., a move that has brought criticism from family-planning advocates, siting the centers provide high-quality care at an efficient price, and serve as an example of an effective use of government funding. FQHC funding has increased by $10 million, or 25 percent, under the Christie administration.

Martin Milita is a Senior Director with Duane Morris Government Strategies working out of Trenton, and Newark New Jersey and Washington, DC. Based on his appointment as New Jersey's Medicaid Fraud Control Director and his work since then Martin Milita now represents FQHCs, hospitals and health care and technology firms in the health care field.

Protecting New Jersey’s Waterways from Potential Environmental Hazards

Martin Milita is senior director with Duane Morris Government Strategies, a business consulting firm affiliated with the international law firm Duane Morris LLP. Beginning in 2014, Martin Milita has served under appointment by the New Jersey Department of Environmental Protection as a monitor of one of the state’s solid waste, recycling, and transportation companies. Previously he served as deputy attorney general in the state’s division of criminal justice as chief of the solid waste unit. 

Hydraulic fracturing drilling is spurring the current boon in America’s energy sector but byproducts from the drilling process pose potential environmental hazards that remain largely unregulated at the federal government level. Oversight by the U.S. Environmental Protection Agency (EPA) of the drilling process is limited to regulation of drilling emissions only, as underground injections from drilling are exempted from federal Safe Water Drinking Act provisions by the Energy Policy Act of 2005. Although hydraulic fracturing drilling has not yet come to the shores and inlands of New Jersey, drilling is conducted in neighboring states of Pennsylvania and New York. Wastewater with possible environmental hazards created by hydraulic fracturing drilling in these contiguous states creates the need for wastewater storage and treatment in neighboring landfills as well as the potential for wastewater runoff and seepage into New Jersey’s waterways. 

Because federal oversight of hydraulic fracturing drilling is limited, New Jersey state legislators moved to curtail and shut off the potential for state water environmental damage from other states’ drilling wastewater. Voting 4-1, the state’s Senate Environmental and Energy Committee adopted legislation that blocks the storage and treatment of hydraulic fracturing drilling wastewater in New Jersey. In addition, the bill passed by the state senate prohibits the disposal of hydraulic fracturing wastewater into New Jersey waterways.

NJSBA Helps New Jersey Lawyers Acquire Mandatory Continuing Education

Operating out of the Newark and Trenton, New Jersey, offices of the government and business consulting services company Duane Morris Government Strategies, Martin Milita serves as a senior director handling government affairs in New Jersey. Admitted to the bar in New Jersey, Martin Milita received a juris doctor from the James E. Beasley School of Law at Temple University. He is also a member of the Administrative and Business Law sections of the New Jersey State Bar Association (NJSBA). With more than 18,200 members, NJSBA is a voluntary membership organization that supports New Jersey attorneys in their practice by creating professional networks within individual practice areas and providing a collection of resources, including seminars and materials designed to assist members in meeting mandatory continuing legal education (CLE) requirements.

NJSBA is organized into 36 sections focused on distinct areas of legal practice. Together, the sections represent an array of fields ranging from lesbian, gay, and transgender rights to dispute resolution. By joining sections related to their specific areas of practice, NJSBA members are able to network with colleagues and participate in seminars and workshops covering the latest issues in their specific fields of practice.

Sections also assist members to comply with the 2010 order of the New Jersey Supreme Court’s Board on Continuing Legal Education that all licensed lawyers in the state complete 24 hours of CLE every two years. NJSBA sections and committees regularly hold meetings where CLE seminars are available to members. Attorneys who attend a New Jersey Institute for Continuing Legal Education (NJICLE) seminar sponsored by their section receive a 25% discount. A division of the NJSBA, NJICLE annually offers more than 275 live and online CLE seminars each year and produces CLE lecture handbooks and legal education software designed for lawyers.

Furthermore, NJSBA maintains an online library of CLE content that is accessible by all members. At least 4 hours of mandatory CLE must pertain to ethics and professionalism, and material elaborating on these subjects is included among the library's resources, as well as text covering a diversity of other discrete topics related to legal practice.