Compliance News Roundup: Medical Necessity is a Necessity

Compliance News Roundup: Medical Necessity is a Necessity

Posted by Healthicity
Sep 11, 2019 10:38:34 AM

1. Billing Company Owner Sentenced to Prison for Fraud - Cindy Dahdah, 61, the owner of a medical and dental billing company in Beavercreek, Ohio was recently sentenced to 60 months in prison for her role in committing more than $2 million in healthcare fraud. According to court documents, she and her late husband, Dr. Salim Dahdah, provided medically unnecessary medical tests and procedures, exposing countless patients to  serious risks of physical harm. Get the full scoop >> 

2. Community Hospital to Pay $2.4 Million to Settle Claims for Medically Unnecessary Services - Millcreek Community Hospital, located in Erie, Pennsylvania,  recently agreed to pay $2,451,000 in order to resolve claims they violated the False Claims Act. According to documents, an inpatient rehabilitation unit located within Millcreek Hospital had billed Medicare and Medicaid for medically unnecessary inpatient rehabilitation services. Millcreek admitted patients to its inpatient rehabilitation unit who did not qualify, and then they failed to adequately document the inpatient rehabilitation services were medically necessary and reasonable. Get the full scoop >>

3. Deeper Than the Headlines: Can I Pick Your Brain? Audit Results of a Psychotherapist - Medicare pays a lot of money for psychotherapy services nationwide. So it should come as no surprise that the OIG conducted an audit of one particular psychotherapy provider. The report of the audit of Oceanside Medical Group, found some decidedly not intelligent organizational and billing practices. Dive deeper here >>

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