Healthicity Blog

1. Genetic Testing Company Agrees to Pay $1.99 Million to Resolve Allegations of False Claims to Medicare for Medically Unnecessary Tests –

Medicare pays physicians based on diagnostic and procedure codes derived from medical documentation.

For a Medicare patient to be eligible for coverage of post-hospital extended care services, they must be an inpatient in a hospital for not less than 3 consecutive calendar days before being discharged from the hospital.

On January 31, 2005, the OIG published its guidance on the Seven Elements for Effective Compliance.

1. Physician Sentenced to Prison for False Billing Scheme –

Modifier 26 can be confusing, so we’d love to break it down for you.

If you’re a compliance professional at a hospital you are probably aware of the series of compliance reviews that the OIG has been performing for many years.

Compliance formed and quickly evolved since the 1980s after the government paid for hammers that were billed at $435 each and $640 toilet seats and fraud was reported for the Department of Defense contractors.