Healthicity Blog

Most healthcare fraud and abuse cases settle before ever going to trial. However, when they occasionally do go to trial, the outcomes can be as varied as the facts and circumstances of a specific case. A recent trial in Houston didn’t turn out so well for Dr. Ronald Kahn, a Houston physician.

On July 13, 2017, the Department of Justice (DOJ) announced the largest healthcare fraud takedown in history.

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.

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.

In 2009, the HITECH Act was passed as a part of the American Recovery and Reinvestment Act. It provided the authority for the government to establish the Medicare and Medicaid Electronic Health Record (HER) incentive programs to promote the adoption of EHRs.

We all “report up” to somebody at some point and that goes for the OIG, too, in their regular reports to Congress. Recently, the OIG submitted its Semiannual Report to Congress for the period of Oct. 1, 2016 to March 31, 2017.

It’s always interesting to hear a doctor’s perspective on compliance, but it’s even more interesting when that doctor happens to be the OIG’s Chief Medical Officer. I had the pleasure of hearing her, Julie Taitsman, MD, JD, speak at the HCCA’s Regional Compliance Conference this May in New York...

“…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.