Archive for October 2015
How whistleblowers are helping to fight healthcare fraud
Earlier this month, the Department of Justice announced it had resolved a $237 million judgment against Toumey Healthcare System in South Carolina for violations of the Stark Law. In this particular case, the hospital was alleged to have entered into contracts with 19 specialists that required them to refer their outpatient procedures to the hospital…
Read MoreICD-10: How is your practice handling the transition?
It’s been a few weeks since the launch of ICD-10 and there have been a number of stories written about some of the challenges that healthcare providers are facing and how the new billing codes are having an impact on their practices and patient care. Although still early in its implementation, it appears those who…
Read MoreMove quickly to abjure wrongdoing as biller gets prison time for fraud
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…
Read MoreOMHA to expand Medicare appeals process
Faced with skyrocketing processing times, the Office of Medicare Hearings and Appeals (OMHA) says it plans to expand its Settlement Conference Facilitation pilot project in an effort to clear through the ever-growing backlog of claims appeals. The pilot project, which began in June 2014, is an alternative dispute resolution process. It was created to bring…
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