Healthicity Blog

“…let me be clear: healthcare fraud is a priority for the Department of Justice,” is how Kenneth Blanco, acting Assistant Attorney General of the DOJ’s Criminal Division, began his speech on May 18, 2017, at the Institute on Health Care Fraud of the American Bar Association.

Hey compliance peeps! I’m pretty excited about this deeper than the headlines topic this week because I’m pretty sure you folks are going to be into it because it will make you look like a total rockstar and help you nail compliance.

When we hear of doctors, hospitals and other healthcare providers settling False Claims Act allegations with the government, we frequently learn that the accusations were first raised by a current or former employee or another healthcare provider such as a physician.

Annually, the Centers for Medicare and Medicaid Services (CMS) publishes its Fee-For-Service (FFS) Improper Payment Report, a result of the accumulated totals of the Comprehensive Error Rate Testing (CERT) audits.

For the first time in 25 years, on July 2015, the Centers for Medicare and Medicaid Services (CMS), published the first major set of proposed changes to the requirements for participation for long-term care facilities.

Welcome to part two of this three part series where I discuss six important lessons we can all learn from the OIG’s audits of physician E/M services.

Welcome to part one of this three part series where I’ll cover six important lessons we can all learn from the OIG’s audits of physician E/M services.

Organizations that fail to report overpayments within 60 days can be liable under the False Claims Act and may be subject to civil/criminal liabilities.