Healthicity Blog

1. Los Angeles Hospital Agrees to Pay $42 Million to Settle Alleged False Claims Act Violations Arising from Improper Payments to Physicians -

$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 -

When compliance officers hear of healthcare organization settlements associated with compliance problems, they’re typically hearing of settlements engineered by a government agency such as the U.S. Department of Justice or the HHS Office for Civil Rights.

1. Genesis Healthcare agrees to pay $53.6M to settle fraud allegation - “Pennsylvania-based Genesis Healthcare Inc. has agreed to pay the federal government $53.6 million to settle six False Claims Act lawsuits that accused the company of defrauding government healthcare programs.

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. Miami-Area Man Charged For Role in $63 Million Health Care Fraud Scheme - A Miami-area man was charged in an indictment unsealed today for his alleged participation in a $63 million health care fraud scheme involving a now-defunct community mental health center located in Miami. Read the full...