Healthicity Blog

Compliance officers don’t necessarily need to know everything about medical coding and modifiers, but at a minimum, compliance officers should know that modifiers matter.

1. Blood Testing Lab Quest Diagnostics to Pay $6 Million to Settle Healthcare Whistleblower’s Allegations of Kickbacks and Unnecessary Testing -

1. Administrator of Miami - Area Home Health Agency Sentenced to 126 Months in Prison for Involvement in $2.5 Million Medicare Fraud Scheme -

1. The University of California at Riverside’s Pilot Payroll Certification System Did Not Provide Accountability Over Payroll Charges to Federal Awards (A-04-13-01026) -

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.

Most of us by now have heard of the Yates’ Memo that directs the Department of Justice attorneys to hold individuals accountable for inappropriate actions associated with corporate wrongdoing. Since the memo, there’s been an increase of corporate accountability in the headlines, which demonstrates...

1. Houston doctor is eighth person convicted in $13 million healthcare fraud case: A Houston physician was convicted in federal court Wednesday for his role in a $13 million fraudulent Medicare billing scheme involving hundreds of patients-for-hire.

In December of 2016, the U.S. Attorney’s Office for the Southern District of Florida announced a $12 million settlement with South Miami Hospital regarding allegations of medically unnecessary cardiac electrophysiology studies and other procedures allegedly performed by John R. Dylewski, M.D.