Healthicity Blog

The HHS OIG has added to their work plan an analysis of Medicare Advantage Enrollment. According to OIG, the Medicare Advantage program is vulnerable to schemes designed to increase Medicare Advantage organization (MAO) profits by improperly influencing enrollment. They explained that known...

Durable Medical Equipment

For decades compliance professionals have been reading Department of Justice press releases related to fraud, waste, and abuse involving durable medical equipment (DME). DME includes prosthetics, orthotics, and supplies (also known as DMEPOS).

The OIG added some new Work Plan items that compliance teams should keep on their radar. Here are a few key updates.

Medicare Advantage Compliance Under the Spotlight: Lessons from Cigna's $172 Million Settlement

$172 million is a lot of money. It's also the amount that the Cigna Group recently agreed to pay to resolve allegations it violated the False Claims Act in relation to its Medicare Advantage (MA) plan...

The U.S. Department of Health and Human Services Office of Inspector General (OIG) added a large number of new items to its Work Plan in July – more than previous months. Let's take a closer look at some key highlights.

Every year, CMS increases the number of Risk Adjustment Data Validation (RADV) audits

1. $5 Million False Claims Act Settlement -

1. Medicare Advantage Provider to Pay $30 Million to Settle Alleged Overpayment of Medicare Advantage Funds –