Healthicity Blog

1. Doctor Convicted in $8.9 Million Health Care Fraud Scheme –“A federal jury found a physician guilty today for her role in a scheme involving approximately $8.9 million in fraudulent Medicare claims

Training practitioners to better document their visits seems to spark frustration like nothing else among auditors, so much so that auditing forums are full of auditors asking for tips and tricks of the trade.

The OIG continues its voice of concern over opioid overutilization and misuse in the context of Medicare and Medicaid.

Let’s say you’re a Medicare Advantage organization and one day you receive a notification from CMS that you’ve been selected for a program audit. What should you do?

1. Kinderhook Podiatrist Sentenced for Health Care Fraud – “Perrin D. Edwards, D.P.M., age 65, of Kinderhook, New York, was sentenced today to 1 year of probation

You might be using an outside billing company, a central business office or practice staff to provide medical billing services. And you might be feeling pretty great about the work they do.

The OIG recently posted new work plan items in their May 2018 update online. There are two items in particular that I think all of you need to know more about.

CMS won’t be enforcing the Affordable Care Act’s Skilled Nursing Facilities compliance requirement until November of 2019.