Healthicity Blog

Most healthcare fraud and abuse cases settle before ever going to trial. However, when they occasionally do go to trial, the outcomes can be as varied as the facts and circumstances of a specific case. A recent trial in Houston didn’t turn out so well for Dr. Ronald Kahn, a Houston physician.

The DOJ just announced its biggest healthcare enforcement action in history. Compliance personnel will definitely want to know the details since over 100 physicians, nurses or other clinicians were individually indicted.

On July 13, 2017, the Department of Justice (DOJ) announced the largest healthcare fraud takedown in history.

Recently, I talked with Christopher Chandler, a senior consultant at a large medical group in the professional coding and reimbursements department. Christopher explained a whole slew of surgical coding misunderstandings like confusion about how ICD coding works with CPT coding and what to do with...

1. 3 Ways To Measure The Effectiveness Of Your Compliance Program: It’s important to have an effective compliance program but sometimes it can be pretty difficult to measure the success.

Gone are the days when compliance was viewed as less important than other departments in healthcare. Compliance is vital and with its importance comes great responsibility.

Compliance officers must adapt to the ever-changing rules and regulations.

$8.18 Billion is a lot of money. It’s not the amount recovered by the government from healthcare fraud and abuse. It’s not the amount of money provided in charity care by hospitals.

When compliance officers hear of healthcare organization settlements associated with compliance problems, they’re typically hearing of settlements engineered by a government agency such as the U.S. Department of Justice or the HHS Office for Civil Rights.