Remove 2013 Remove Compliance Remove Fraud Remove Medicare
article thumbnail

Safeguarding Against Medical Identity Theft Training

American Medical Compliance

When someone uses your personal information, such as your name, Social Security number, or Medicare number, to make false claims to Medicare and other health insurers without your consent, it is known as medical identity theft. To become certified, please visit us at: American Medical Compliance (AMC). trillion in 2015.

Fraud 52
article thumbnail

Understanding Compliance for Healthcare Vendors

Provider Trust

So what does that mean for your healthcare organization’s compliance program? Is your organization properly vetting and monitoring compliance of your entire vendor network? Which regulations govern vendor compliance?

Insiders

Sign Up for our Newsletter

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

article thumbnail

Eye Specialist Fined $907,074.64 for Medically Unnecessary Treatments

Med-Net Compliance

to resolve allegations that they submitted false claims to Medicare and Medicaid. The ophthalmologist was identified by HHS-OIG as one of the top outliers for billing the Medicare program across all medical specialists in West Virginia, far exceeding the average of Medicare claims submitted by his peers.

article thumbnail

How HHS-OIG, Regulators Enforce Vendor Compliance

Provider Trust

What the HHS-OIG says about vendor compliance. Additionally, check out this HHS-OIG 2016 report, Medicare: Vulnerabilities Related to Provider Enrollment and Ownership Disclosure , which revealed “vulnerabilities that could allow potentially fraudulent providers to enroll in the Medicare program.”. Case Study: S.

article thumbnail

Oklahoma Hospital Pays over $1.1 Million to Settle False Claims Act Allegations

Healthcare Compliance Blog

million to settle allegations that it violated the False Claims Act by submitting false claims to Medicare. The voluntary disclosure and investigation revealed that from June 1, 2013, through May 31, 2019, the hospital submitted claims to Medicare for Intensive Cardiac Rehabilitation (ICR) services provided to Medicare beneficiaries.?Before

article thumbnail

DOJ Settles Self-Reported Referral Incentives With Dermatology Practice Manager

McGuire Wood

According to the DOJ press release, from January 2013 to July 2018, Oliver Street, doing business as U.S. The disclosure noted that claims for certain referred services were submitted for payment to Medicare, thus invoking the reach of the implicated federal laws. Care in email and transactional slides is warranted.

Fraud 52
article thumbnail

Editorial: 5 Gaps in HIPAA and How They Are Being Filled

HIPAA Journal

For example, the Administrative Requirements (Part 162) helped reduce insurance fraud and accelerated eligibility inquiries, authorization requests, and claims processing. In 2013, HHS confirmed that paper-to-paper, non-digital faxes are not covered transactions).

HIPAA 95