Healthicity Blog

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.

1. Electronic Health Records Vendor To Pay The Largest Settlement In The District Of Vermont: eClinicalWorks LLC to Pay $155 Million to Resolve Civil False Claims Act Allegations –

“What are the first steps I should take to improve my compliance program right now?”

To put it simply: The more you know, the better off you’ll be. A great compliance program starts with knowledge of compliance, rules and regulations, and best practices.

Often, compliance officers are left alone in their own department to do their own things. It can become a little isolating. So, it’s always important to find a trusted person to talk with about compliance issues.

Compliance officers have a lot to juggle. Incident management, internal auditing and monitoring, and enforcing standards, are just a few of the things you need to master. Plus, it seems like new guidelines are emerging from every corner.

“…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.