Compliance News Roundup: Feb 2019 OIG Work Plan Additions

1. Prime Healthcare Services and CEO, Dr. Prem Reddy, to Pay $1.25 Million to Settle False Claims Act Allegations – “U.S. Attorney William M. McSwain announced today that Prime Healthcare Services, Inc. (“Prime”) and Prime’s Founder and Chief Executive Officer, Dr. Prem Reddy, have agreed to pay the United States $1.25 million to settle allegations that two Prime hospitals in Pennsylvania – Roxborough Memorial Hospital in Philadelphia and Lower Bucks Hospital in Bristol – knowingly submitted false claims to Medicare by engaging in the following conduct: (1) admitting patients to the hospital for overnight stays who required only less costly, outpatient care and (2) billing for more expensive patient diagnoses than the patients had (the latter practice known as “upcoding”).” Get the full scoop  >>

2. Baton Rouge Doctor and His Medical Billing Supervisor Plead Guilty to Fraudulent Billing Scheme – “A Baton Rouge, Louisiana-based doctor pleaded guilty yesterday and his medical billing supervisor pleaded guilty today for their roles in a scheme to defraud Medicare and other health care insurers.” Get the full scoop >>

3. Deeper Than the Headlines: Feb 2019 OIG Work Plan Additions – In February 2019, the OIG has made multiple additions to its Workplan. There are some significant additions, so let’s look at a few of them, including Medicare Part B payments for podiatry and ancillary services, and NIH's implementation of financial conflict of interest regulations, and much, much, more! Get the full scoop >>