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CMS announces new payment model for primary care physicians

The Centers for Medicare and Medicaid Services (CMS) last week announced a new risk-based primary care initiative designed to “transform ...
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Healthcare Fraud and Abuse Crackdown Not Slowing as Evidenced by Recent Cases

The federal government has been busy since the beginning of the year announcing arrests, convictions and settlements relating to healthcare ...
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CMS proposes new payment model for Medicare Part B

The Centers for Medicare and Medicaid (CMS) is proposing a new rule that could result in a new Medicare Part ...
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OCR launches Phase 2 HIPAA Audits

The U.S. Department of Health and Human Services Office of Civil Rights has launched Phase 2 of its long-awaited HIPAA ...
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Government recovers $1.9 billion in healthcare fraud judgments and settlements in FY 2015

A newly released report by the Health Care Fraud and Abuse Control Program (HCFAC) shows that the federal government won ...
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Lessons learned from whistleblower FCA case against cancer treatment company

Earlier this month, the U.S. Department of Justice announced that 21st Century Oncology and its wholly owned subsidiary, South Florida ...
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GAO: Smart cards not a viable weapon in battle against healthcare fraud

There’s been a lot of debate in the last few years over the value of smart cards in the war ...
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CMS issues new condition code for home health claims

The Centers for Medicare and Medicaid Services (CMS) has added a new condition code that will allow home health claims ...
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CMS clarifies 60-day overpayment rule

The Centers for Medicare & Medicaid Services (CMS) has published its long-awaited final rule that details the reporting and returning ...
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TRICARE Billing Scandal Intensifies as Feds Target More Compounding Pharmacies

Allegations of fraudulent billing practices involving compounding pharmacies and specialty creams is rearing its ugly head again. Now, the U.S. ...
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