Archive for May 2019
Incident-to Billing Investigation Ends in $118,000 Fine
A physician in Texarkana, Texas recently agreed to pay $118,000 to settle allegations he engaged in improper billing practices for his Medicare patients at three of his clinics. According to the allegations, Dr. Donald S. Douglas’ advanced practice nurses (APNs) were hired to assist him with seeing patients in his clinics. By law, if the…
Read MoreFlorida’s Behavior Analysts Make Some Strides
Last month, we wrote about Florida’s Agency for Health Care Administration (AHCA) decision to postpone planned cuts to Medicaid reimbursement rates for behavioral health therapists. But at that time, AHCA did not specify for how long the postponement would last. Now, we learn from the Florida Association for Behavior Analysis that the Florida Legislature is…
Read MoreDoD Wants to Impose CMPs on Those Who Defraud TRICARE
Plagued by fraud and abuse targeting its TRICARE program, the U.S. Department of Defense, on May 1, issued a proposed rule that would allow it to impose civil monetary penalties (CMPs) against providers and suppliers who commit fraud and abuse against the TRICARE program. The new rule would create the “Military Health Care Fraud and…
Read MoreHHS Makes Changes to HIPAA Civil Monetary Penalty Caps
The U.S. Department of Health and Human Services (HHS) has issued a notification that it is changing the way it applies the assessment of Civil Money Penalties (CMPs) against those who violate the Health Insurance Portability and Accountability Act of 1996 (HIPAA), as amended by the Health Information Technology for Economic and Clinical Health (“HITECHâ€)…
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