Healthicity Blog

An organization that fails to create and maintain an effective compliance program could be forced to return overpayments. And providers may face severe civil, criminal, and financial penalties.

1. Mylan Agrees to Pay $465 Million to Resolve False Claims Act Liability for Underpaying EpiPen Rebates - “Pharmaceutical companies Mylan Inc. and Mylan Specialty L.P. have agreed to pay $465 million to resolve claims

1. Fort Worth Brothers Admit Role in $36 Million Lab Test Kickback Scheme - Two Fort Worth men pleaded guilty Friday afternoon to playing a role in an alleged $36 million fraud scheme involving unnecessary lab tests of saliva and urine that were billed to the U.S. military’s health care system.

Auditing and Monitoring: One of the 7 Elements of an Effective Compliance Program

The OIG frequently creates and shares short videos about important compliance topics in their series, “Eye on Oversight.” Their most recent release demonstrates the importance of OIG Audits.

You want to improve your compliance program but just don’t have the time for a total overhaul at the moment. Well, have no fear, because there are a few small tweaks you can make that can have a huge impact on your program. And the good news is that it’s easier than you think.

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.

For this episode of Compliance Conversations, I sat down with Chad Peterson, a senior consultant at a large hospital, in their professional coding and reimbursement group. He educates physicians, mid-level providers/ advanced practice providers and even ancillary staff about E/M coding.