Healthicity Blog

The OIG has frequently reviewed chiropractic services over the last several years. Their most recent report was posted on their website on Aug. 18, 2017 and concluded that a Brooklyn chiropractor had a 100% error rate for claims over a two-year period worth about $672,000.

Hey compliance peeps! I’m pretty excited about this deeper than the headlines topic this week because I’m pretty sure you folks are going to be into it because it will make you look like a total rockstar and help you nail compliance.

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.

1. OIG report: Vidant Medical Center Incorrectly Billed Medicare Inpatient Claims with Severe Malnutrition (A-03-15-00011) - Vidant Medical Center (the Hospital), in Greenville, North Carolina, complied with Medicare billing requirements for diagnosis codes 261 and 262 for 11 of the 100 claims that...

1. Rio Grande Valley Area Doctor Charged in Illegal Kickback Scheme - McALLEN, Texas ‐ A Rio Grande Valley area doctor has been taken into custody for his scheme to solicit and obtain illegal kickbacks in exchange for Medicare patient referrals, announced U.S. Attorney Kenneth Magidson.

A couple weeks ago, Medstar Ambulance Inc. settled False Claims Act allegations with the government for $12.7 million. The allegations were first brought to the attention of the government through a former billing office employee who filed a qui tam (i.e., whistleblower) lawsuit under the False...

In Medicare and Medicaid services, managed care plans fall under Part C, a Medicare Advantage plan alternative to Parts A and B. Medicare Advantage plans often include integrated self-administered drug coverage similar to the standalone Part D prescription drug benefit plan.

In our last blog post we talked about the inception of the RAC program. In this blog post we’ll cover expectations for 2016 and some enhancements and expansions to be aware of.