Healthicity Blog

1. Pitt County Behavioral Health President Pleads Guilty to Medicaid Fraud Conspiracy and Perjury Charges - “The United States Attorney for the Eastern District of North Carolina John Stuart Bruce Office announced that yesterday in federal court, Shephard Lee Spruill, II, 46, of Winterville, North...

Sensegiving in Change Management

Recently, I was talking with a friend, a long-time compliance colleague. As we grew more comfortable in the conversation, he confided in me some current frustrations in his compliance leadership role.

1. 3 Ways To Measure The Effectiveness Of Your Compliance Program: It’s important to have an effective compliance program but sometimes it can be pretty difficult to measure the success.

Gone are the days when compliance was viewed as less important than other departments in healthcare. Compliance is vital and with its importance comes great responsibility.

Compliance officers must adapt to the ever-changing rules and regulations.

$8.18 Billion is a lot of money. It’s not the amount recovered by the government from healthcare fraud and abuse. It’s not the amount of money provided in charity care by hospitals.

1. Orlando Doctor and Infusion Clinic Owner Sentenced to 64 Months and 90 Months in Prison for Role in Medicare Fraud -

In this episode of Compliance Conversations, I sat down with Senior Consultant, Brenden O’Neil, who works in Intermountain’s professional coding and reimbursement department. O’Neil and I had a fascinating discussion on CPT codes and the complicated gray area of coding a laminectomy.

Compliance officers don’t necessarily need to know everything about medical coding and modifiers, but at a minimum, compliance officers should know that modifiers matter.