Healthicity Blog

1. Doctor Convicted in $8.9 Million Health Care Fraud Scheme –“A federal jury found a physician guilty today for her role in a scheme involving approximately $8.9 million in fraudulent Medicare claims

The OIG continues its voice of concern over opioid overutilization and misuse in the context of Medicare and Medicaid.

Let’s say you’re a Medicare Advantage organization and one day you receive a notification from CMS that you’ve been selected for a program audit. What should you do?

The OIG recently posted new work plan items in their May 2018 update online. There are two items in particular that I think all of you need to know more about.

CMS won’t be enforcing the Affordable Care Act’s Skilled Nursing Facilities compliance requirement until November of 2019.

1. Ohio Hospital Operator Agrees to Pay United States $14.25 Million to Settle Alleged False Claims Act Violations Arising From Improper Payments to Physicians –

As compliance professionals, we tend to focus on large dollar settlements to raise awareness within our organization. These type of events can definitely make some executives pay attention.

Recently, a $3.5 Million HIPAA settlement was announced on HHS.gov, “Fresenius Medical Care North America (FMCNA) has agreed to pay $3.5 million to the U.S. Department of Health and Human Services