Healthicity Blog

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.

1. Missouri Hospitals to pay U.S. $34m to settle alleged false claims: Two Southwest Missouri health care providers have agreed to pay the United States $34,000,000 to settle allegations that they violated the False Claims Act by engaging in improper financial relationships with referring...

“…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.

When we hear of doctors, hospitals and other healthcare providers settling False Claims Act allegations with the government, we frequently learn that the accusations were first raised by a current or former employee or another healthcare provider such as a physician.

“Although compliance program design is not a “one size fits all” issue, Boards are expected to put forth a meaningful effort....”.

We all know the value of getting your board on board with compliance.

Though whistleblower settlements don’t necessarily seem to be slowing down, it does seem that the government is announcing more and more settlements that appear to have originated from government data mining as opposed to whistleblowers.