Healthicity Blog

“Compliance professionals were people before they were in compliance,” Rudy Green joked when I sat down with him for our most recent episode of Compliance Conversations.

One of the seven elements of an effective compliance program is establishing a compliance officer.

It’s that time of year again! Compliance programs are performing annual risk assessments and creating annual audit work plans in preparation for 2018.

The number of settlements with the government for issues of non-compliance are on the rise. And experts estimate that most physician practices are making mistakes.

For those of you unfamiliar with coding and billing, modifier -59 is a two-digit numeric code modifier that can be appended to a CPT or HCPCS procedure code, for example, and will frequently bypass many payor edits.

1. Huntsville Nursing Home Pays the United States and the State of Texas $5 Million to Settle Claims Alleging Poor Quality of Care –

Though many CIAs read very similarly, it’s good practice to read new ones to reaffirm some of the core principles of an effective compliance program.

In May of 2017, two Southwest Missouri health care organizations agreed to pay the United States $34,000,000 to settle allegations that they violated the False Claims Act by engaging in inappropriate financial relationships with referring physicians, wrote the US Department of Justice.