1. Medicaid Fraud Control Units: Investigation and Prosecution of Fraud and Beneficiary Abuse in Medicaid Personal Care Services – “OIG has conducted numerous audits, evaluations, and investigative work involving personal care services (PCS) and offered recommendations for improving program oversight. Medicaid Fraud Control Units (MFCUs or Units) investigate and prosecute Medicaid provider fraud and patient abuse or neglect under State law. We conducted this study to provide data on MFCU investigations, indictments, and convictions involving fraud and patient abuse in Medicaid PCS.” Get the full scoop >>
2. 21st Century Oncology to Pay $26 Million to Settle False Claims Act Allegation – “21st Century Oncology Inc. and certain of its subsidiaries and affiliates have agreed to pay $26 million to the government to resolve a self-disclosure relating to the submission of false attestations regarding the company’s use of electronic health records software and separate allegations that they violated the False Claims Act by submitting, or causing the submission of, claims for certain services provided pursuant to referrals from physicians with whom they had improper financial relationships.” Get the full scoop >>
3. Deeper Than the Headlines: The OIG Update: Advisory Opinion December 2017 – The OIG posted their most recent advisory opinion (AO) on Dec. 11th, 2017. Let’s talk about the OIG’s most recent advisory opinion. The AO is a response to a proposal by a pharmaceutical manufacturer to collaborate with a trade association, a Medicare Advantage plan, and a hospital system. They want to collaborate in order to implement, fund, and evaluate a pilot program to provide the Medicare Advantage plan pharmacists who conduct medication therapy management services with new technology that would permit real-time electronic access to patient discharge information. Get the full scoop >>
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