Compliance News Roundup: Is Your Compliance Committee Even Effective?

1. Under ‘Observation,’ Some Hospital Patients Face Big Bills - “In April, Nancy Niemi entered Vidant Medical Center in Greenville, N.C., with cardiac problems. She stayed four nights, at one point receiving a coronary stent.

Then she went home, but felt faint and took several falls. Five days later, her primary care doctor sent her back to the hospital. This time, her stay lasted 39 days while physicians tried various medications to regulate her blood pressure. Though they eventually succeeded, Mrs. Niemi, 84, a retired insurance agent, had grown so weak that she could no longer walk.

“They said, ‘She really needs to go to a skilled nursing facility for physical therapy,’” recalled her son Tom Krpata, 63, who’d come from his home in Holliston, Mass., to be with her.

He agreed, but soon learned one of the brutal truths of Medicare policy: Patients can be hospitalized for days, can undergo exams and tests, can receive drugs — without ever officially being admitted to the hospital.” Get the full scoop >>

2. Detroit Area Medical Biller Sentenced to 50 Months in Prison for Her Role in a $7.3 Million Dollar Healthcare Fraud Scheme - “A Detroit-area medical biller was sentenced today to 50 months in prison for  her role in a $7.3 million Medicare and Medicaid fraud scheme involving medical services that were billed to Medicare and Medicaid but not rendered as billed.” Get the full scoop >>

3. Deeper Than the Headlines: Is Your Compliance Committee Even Effective? - If you have a compliance program, you most likely have a full-time compliance officer or an individual who is accountable for your organization’s compliance program, even if it’s only a portion of that person’s overall duties.  But, does your organization have a compliance committee?  And if so, is it really effective? Get the full scoop >>

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