Healthicity Blog

1. Kinderhook Podiatrist Sentenced for Health Care Fraud – “Perrin D. Edwards, D.P.M., age 65, of Kinderhook, New York, was sentenced today to 1 year of probation

The OIG recently posted new work plan items in their May 2018 update online. There are two items in particular that I think all of you need to know more about.

The OIG has added seven new items to their work plan in March 2018. Let’s look at a few of them a little more closely.

1. Scripps Health to Pay $1.5 Million to Settle Claims for Services Rendered by Unauthorized Physical Therapists –

The OIG has updated their work plan with its January 2018 additions. Let’s take a deep dive into the updates and what they mean for you as a compliance professional.

1. Attorney General Josh Stein Announces Sentencing In Fayetteville/Raeford Medicaid Fraud Case –

We talk a lot about the OIG. So much so that we use the term “OIG” to generally mean the OIG for the Federal Department of Health and Human Services. It is important to stay on top of the Federal OIG work plan, audits, investigations and other initiatives.

For those of you unfamiliar with coding and billing, modifier -59 is a two-digit numeric code modifier that can be appended to a CPT or HCPCS procedure code, for example, and will frequently bypass many payor edits.