Healthicity Blog

Most healthcare fraud and abuse cases settle before ever going to trial. However, when they occasionally do go to trial, the outcomes can be as varied as the facts and circumstances of a specific case. A recent trial in Houston didn’t turn out so well for Dr. Ronald Kahn, a Houston physician.

The DOJ just announced its biggest healthcare enforcement action in history. Compliance personnel will definitely want to know the details since over 100 physicians, nurses or other clinicians were individually indicted.

1. Justice Department reaches first settlement with opioid manufacturer - “The Justice Department and Mallinckrodt Pharmaceuticals reached a $35 million settlement Tuesday to resolve allegations that the company failed to report signs that large quantities of its highly addictive oxycodone pills...

On July 13, 2017, the Department of Justice (DOJ) announced the largest healthcare fraud takedown in history.

Auditors, unite! Below you’ll find a roundup of education and certification resources for auditors. In every industry, education and networking are key to career growth and personal development. So, join an organization, attend a conference, or sign up for a course.

Recently, I talked with Christopher Chandler, a senior consultant at a large medical group in the professional coding and reimbursements department. Christopher explained a whole slew of surgical coding misunderstandings like confusion about how ICD coding works with CPT coding and what to do with...

1. Most Hated Man in Healthcare’ Trial Underway: “Martin Shkreli, the ‘most hated man in healthcare,’and former pharmaceutical executive who gained notoriety for hiking up the price of a life-saving drug, will finally go on trial Monday on charges of ripping off investors.”

Every auditor faces different challenges. Some of us get stuck on MIPS, while others struggle with HCC. The one area that seems to really stump all of us across the board is Medical Decision Making.