Archive for October 2018
CMS Proposes Changes Designed to Speed up Medicare Appeals Process
It’s been a while since we last updated you on the latest about the Medicare appeals backlog, which although it has decreased some, remains troublesome. To further address the issue, The Centers for Medicare & Medicaid recently proposed revising its rules that govern the appeals process in an effort to further streamline it and reduce…
Read MoreHealthcare exec pleads guilty to multimillion-dollar opioid scheme
A Michigan healthcare CEOrecently pleaded guilty to taking part in a $300 million healthcare fraud scheme that, in the words of U.S. Attorney Jeff Sessions, “flooded the streets†with millions of doses of opioids and other controlled substances. Mashiyat Rashid was CEO of the Tri-County Wellness Group of medical providers which operated pain clinics and…
Read MoreOIG Unveils Fraud Risk Indicator
The Health and Human Services Office of Inspector General has launched a new initiative designed to draw attention to those healthcare providers it considers to be high risk for committing healthcare fraud after having been charged under the False Claims Act. The OIG posted this Fraud Risk Indicator on its website after Gregory Demske, the…
Read MoreTis the Season: Gifts to Medicare Patients Nice Gesture or a Crime?
As we approach the holidays, now may be an appropriate time to point out the rules relating to gifts that providers can give to Medicare and Medicaid beneficiaries. During this time of the year, some healthcare professionals may want to give gifts to their patients, other physicians or even referral sources. Before you do, consider…
Read MoreObstructing Medicare Audit Can Get You Jail Time
A 73-year-old Port Charlotte, Florida endocrinologist was recently sentenced to five months in prison, to be followed by three years of supervised release, for obstructing a Medicare audit. In addition, Dr. John Janick will have to pay $118,831.62 in restitution to the Medicare program. Janick, who reached a plea agreement, is alleged to have lied…
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