Compliance News Roundup: OIG Continues Their Hospital Compliance Reviews with the University of Michigan

1. Roseville Dermatologist Accused Of Billing Patients For Procedures Never Performed – “A 72-year-old dermatologist practicing in Roseville has been charged with multiple counts of fraud after she allegedly billed patients for procedures that were not performed. Dr. Usha Sood was arraigned Thursday on five counts of Medicaid fraud – false claim. Bond was set at $250,000 and Sood must also surrender her passport. She’s due back in court Feb. 9.” Get the full scoop >>

2. DOJ Seeks to Curtail Soaring False Claims Act Cases – “DOJ seeks to curtail soaring False Claims Act cases- A U.S. Department of Justice memo, revealed last week, that guides its attorneys on when they should seek dismissal of False Claims Act whistleblower cases could lead to a decline in the soaring number of lawsuits filed, although its ultimate impact remains unclear, observers say.

Over the last 10 years, there have been record increases in qui tam, also known as whistleblower, cases filed under the False Claims Act, with annual totals approaching or exceeding 600 new matters, said Michael D. Granston, director of the Justice Department’s commercial litigation branch, fraud section, in a memo to department attorneys.” Get the full scoop >>

3. Deeper Than the Headlines: OIG Continues Their Hospital Compliance Reviews with the University of Michigan – For years, the OIG has been performing Hospital Compliance Reviews that are essentially data-driven billing analyses of inpatient and outpatient reimbursement. They base these reviews on risk areas that they identified during prior reviews at other hospitals.

The most recent review just posted by the OIG on Feb. 6, 2018 was performed on services from the University of Michigan’s Health System (the Hospital). Specifically, the audit covered $28,633,879 in Medicare payments to the Hospital for 2,582 claims that were potentially at risk for billing errors. These claims consisted of inpatient and outpatient claims paid to the Hospital for services provided to Medicare beneficiaries during CYs 2014 and 2015. Get the full scoop >>

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