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OIG Cracks Down on Hospice Provider Fraud

Last year, the HHS Office of the Inspector General stated the hospice fraud was rampant and that it would be an enforcement priority for the agency. The OIG found that some hospice operators, doctors and staff were recruiting patients to maximize profits, even when in some cases the patients didn’t need hospice care. Their illegal […]

June a busy month for healthcare fraud enforcement

Individual physicians, medical billers, DME manufacturers, healthcare executives and even entire healthcare systems were on the receiving end of the U.S. Department of Health and Human Services Office of the Inspector General’s (OIG) enforcement efforts last month. In fact, there were 39 actions announced by the IG’s office in June, up from 35 in May […]

New Florida Law Cracks Down on Patient Brokering by Drug Treatment Providers

Effective July 1, drug treatment providers in Florida must comply with stringent new regulations designed to crackdown on corruption within the industry. Late last month, Governor Rick Scott signed into law HB 807, commonly referred to as the “Practices of Substance Abuse Service Providers Act.” The new law provides state regulators with broader powers as […]

Genesis Healthcare Settlement Another Example of Government’s Anti-Fraud Campaign

Whatever else is taking place in the nation’s capital these days, one thing is for certain, there is no letup in the government’s crackdown on healthcare fraud. This is made clear by the continued announcements of multimillion-dollar settlements coming from various fraud-fighting agencies. One of the more recent settlements involves Genesis Healthcare, Inc., a Kennett […]

OIG: CMS Overpaid Providers Millions in EHR Incentive Payments

The Department of Health and Human Services’ Office of Inspector General (OIG) recently released a report finding that the Centers for Medicare & Medicaid Services (CMS) overpaid some $729 million in Medicare electronic health record (EHR) incentive payments to eligible providers who did not comply with federal meaningful use requirements. In its report, the OIG […]

OCR Provides Update on HIPAA Enforcement Efforts

The recent WannaCry ransomware attack impacting hospital and healthcare information systems worldwide shone a bright light on the vulnerabilities of most healthcare provider’s networks. But the problem extends far beyond this one case. In fact, there are near daily reports of patients’ private information being accessed due to a lack of appropriate security measures. And, […]

Billing Medicare for Free Samples Can Land Healthcare Providers in Hot Water

It’s not unusual for physicians to receive free samples to give to their patients. But billing the federal government for them is a definite no-no as one St. Louis, Missouri neurologist recently learned. According to a recent news release from the U.S. Department of Justice, Dr. Sherry X. Ma and her clinic, AIMA Neurology, LLC, […]

Study: Medicare Appeals Process Reforms Not Enough to Eliminate Backlog

The Centers for Medicare & Medicaid Services’ (CMS) current and proposed reforms may not be enough to eliminate the appeals backlog and restore a timely and fair appeals process. That was the finding of a study published recently in the Journal of Hospital Medicine. Researchers investigated all appeals reaching level three at three facilities: Johns […]

Is Your Telemedicine Company HIPAA Compliant?

UPDATE: According to a news release, the lawsuit filed against MDLive, Inc. was voluntarily dropped by the law firm that originally filed it. MDLive has since published a fact sheet responding to the allegations. A lawsuit seeking class action status recently filed against Telehealth provider MDLive, Inc. underscores the need for all healthcare companies using […]

CMS Launches New Online MIPS Tool

The Centers for Medicare and Medicaid Services (CMS) wants to help healthcare providers to determine whether they must take part in the Merit-Based Incentive Payment Program – better known as MIPS. The new Medicare reimbursement program is central to the Quality Payment Program, which intends to shift reimbursement away from the volume of services provided […]