CMS clarifies 60-day overpayment rule

A tablet with a stethoscope on it and the calendar.

The Centers for Medicare & Medicaid Services (CMS) has published its long-awaited final rule that details the reporting and returning of Medicare Part A and B overpayments. The proposed rule left providers asking many questions. The final rule provides needed clarity and consistency in the reporting and returning of self-identified overpayments. It is designed to…

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TRICARE Billing Scandal Intensifies as Feds Target More Compounding Pharmacies

A mortar and pestle with some pills in the background

Allegations of fraudulent billing practices involving compounding pharmacies and specialty creams is rearing its ugly head again. Now, the U.S. Department of Justice is investigating what is suspected to be half a billion dollars in healthcare fraud linked to these creams used to treat pain. TRICARE, the health insurance program for members of the U.S.…

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Social media posts can be used to detect healthcare fraud

A computer monitor with magnifying glass on the screen.

In George Orwell’s novel Nineteen Eighty-Four, citizens of Oceania, a totalitarian state, are under surveillance at all times and constantly reminded that Big Brother is watching them. Today, with the advancement of digital technologies – from cameras on the street and in stores, to cookies gathered from the Internet – most of us are being watched…

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