Medisys Compliance

JULY 29, 2022

We are sharing Medicare guidelines for laser-assisted cataract surgery billing from a last updated CMS document. Medicare Policy Regarding Non-Covered Services. Under either method, Medicare will cover and pay for the cataract removal and insertion of a conventional intraocular lens.

Medicare 52

Medicare Medicare Medical Billing Medical Billing Outsourcing 52

Health Law Advisor

AUGUST 14, 2023

1] With the end of the PHE having occurred over three months ago, that temporary waiver of sanctions ended and can no longer be relied upon for legal compliance with the Stark Law. [2] The IOAS exception does NOT apply.

COVID-19 52

COVID-19 Medicare Medicare Public Health 52

Med-Net Compliance

JULY 20, 2022

A federal jury convicted a New York ENT doctor for defrauding Medicare and Medicaid by causing the submission of false and fraudulent claims for surgical procedures that were not performed. Specifically, between January 2014 and February 2018, the doctor billed Medicare and Medicaid approximately $585,000 and was paid approximately $191,000.

Fraud 59

Fraud Doctors Medicare Medicare 59

Med-Net Compliance

OCTOBER 27, 2022

A federal jury convicted a licensed Illinois psychologist of defrauding Medicare over the course of several years by causing the submission of fraudulent claims for psychotherapy services he never provided. Issue: It is illegal to submit claims for payment to Medicare or Medicaid that you know or should know are false or fraudulent.

Nursing Homes 59

Nursing Homes Fraud US Department of Health and Human Services Nurses 59

Health Law RX

JUNE 2, 2023

The Court’s Supervalu Decision Supervalu involved two combined FCA cases, both brought against supermarkets (Supervalu and Safeway) that house internal pharmacies and that participate with Medicare and Medicaid. [6] per 30-day supply). [9] per 30-day supply). [10] 12] The Court unanimously disagreed. per 30-day supply). [9] SuperValu Inc. ,

Fraud 52

Fraud Governance Medicaid Medicaid 52

Innovaare Compliance

FEBRUARY 9, 2021

Annually, the Centers for Medicare & Medicaid Services (CMS) releases star ratings, which measure the quality of care health plans deliver for its members. Launched in 2007, star ratings enable the CMS as well as consumers to compare health plans on metrics other than cost. Read More – Medicare Star Ratings Changes 2021 .

Medicare 40

Medicare Medicare Medicaid Medicaid 40

Hall Render

APRIL 6, 2022

The relator alleged that these programs and subsequent reporting of the retail price, and not the discounted price, violated Medicare Part D’s requirement that a pharmacy must report the usual and customary price charged for the drugs. SuperValu Inc., of America v. Burr was applicable to lawsuits brought under the False Claims Act.

Medicare 72

Medicare Medicare Medicaid Medicaid 72