Healthicity Blog

For years, the OIG has been performing Hospital Compliance Reviews that are essentially data-driven billing analyses of inpatient and outpatient reimbursement.

For many years now the OIG has been performing Medicare Compliance reviews of hospitals.

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...