$145M landmark settlement largest in DOJ history involving skilled nursing facility Oct. 26, 2016 (MIAMI, FLA.) It was a case that was eight years in the making, but on October 24, Anthony C. Vitale’s hard work and dedication paid off when Life Care Centers of America Inc., and its owner Forrest L. Preston, agreed to […]
Medicare Part B published an article on the sentencing of a biller indicted on charges stemming from a conspiracy to obtain payment on care plan oversight services for patients who were not receiving those services. The article notes that the federal government is using all of its resources to identify and prosecute individuals at all […]
When it comes to reputation Big Pharma has some serious problems, at least according to the 2015 Harris corporate reputation poll. Pharmaceutical companies rank ninth out of 14 industries when it comes to respect – or a lack thereof. There is no question that pharmaceutical companies provide an invaluable public service, but their reputation has […]
The finalization of a Medicare enrollment rule puts your practice in danger of disruption if you haven’t tightened up your personnel practices. Attorney Christopher Parrella talks to Medicare Part B News about the new CMS rule. Click here to read the full article.
CMS has a grand plan to sync up its payment systems by using bundled outpatient codes that many doctors are calling ”mini-DRGs,” after the familiar inpatient diagnosis-related groups. But even if these new bundles are more efficient for CMS, what effect will they have on physician practices? Click here to read the full article.
Ensure your claims accurately portray the services your practice provided — even if you attach a G modifier because you don’t believe you’ll be paid for it. Auditors are paying new attention to those cases. Click here to read the full article
The American Hospital Association (AHA) and 11 hospitals are suing HHS for the backlog of appeals on Recovery Audit Contractor (RAC) claims, saying the government’s process is so ineffective that it is costing healthcare providers millions of dollars. Click here to read the full article
Running a financially successful practice depends on efficient revenue cycle management (RCM). RCM describes all of the steps involved in managing claims processing, payment, and revenue generation, starting with patient scheduling and ending with payment. As practices face heavier workloads, many are evaluating whether to outsource these services. Click here to read the full article
Just about every day there’s at least one story published in a newspaper somewhere in the U.S. about healthcare fraud. It might be about an individual provider who has been arrested, a hospital that is under investigation, or an office employee in a healthcare setting who has been sentenced to jail for their role in […]
In recent years, the federal government has adopted what might be viewed as a “take no prisoners” stance when it comes to healthcare fraud and abuse. The pharmaceutical industry, in particular, has been hit with billions of dollars in fines for fraudulent marketing practices including the promotion of drugs for uses not approved by the […]