When most of us hear about OCR enforcement we immediately think about HIPAA, and rightfully so. There’s no doubt that HIPAA has definitely been a big enforcement area for OCR, but remember that OCR stands for the “Office for Civil Rights” and they oversee other areas of enforcement as well.
1. Dallas-Based Physician - Owned Hospital to Pay $7.5 Million to Settle Allegations of Paying Kickbacks to Physicians in Exchange for Surgical Referrals -
1. McDonough woman pleads guilty to Medicaid fraud, ordered to pay $3.8 million – “The owner of a former Henry County mental health services business will have to pay $3.8 million in restitution to the Georgia Medicaid Program for alleged Medicaid fraud.
“Any company or individual receiving anything of value in exchange for referrals should understand that their actions may have serious legal and financial consequences.”
Those of you who have been following my work on the Healthicity blog, my webinars and/or speaking engagements know that one of my topics of choice is the government's increased efforts to hold individuals, not just organizations, accountable for suspected non-compliance.
1. CMS and Its Claims Processing Contractors Issued Conflicting Guidance on the Proper Use of the KX Modifier for Part B Immunosuppressive Drug Claims - “Medicare Part B paid for some immunosuppressive drugs billed with the KX modifier that were not eligible for Part B payment.