YouCompli

NOVEMBER 1, 2023

As compliance officers, we are continually placed in a position to influence the actions of others and help shape our organization’s compliance culture. One way to change that perception is to avoid creating “gotcha” moments when you’re working on a compliance-related matter. Here are four tips that will help.

Compliance 52

Compliance US Department of Health and Human Services Compliance Officers Overpayments 52

Healthcare IT Today

MAY 5, 2023

Department of Health and Human Services (HHS) analysis showed Medicare payments for genetic testing quadrupled from 2016 to 2019. The surge in genetic testing claims comes with a rise in fraud, waste and abuse across government and commercial payers. In 2021, a U.S. Common schemes include: Code stacking.

Fraud 62

Fraud Medicare Medicare Overpayments 62

Florida Health Care Law Firm

DECEMBER 2, 2021

As described on the OIG website, “Self-disclosures give persons the opportunity to avoid the costs and disruptions associated with a Government-directed investigation and civil or administrative litigation.”. Any overpayment retained after this period may create liability under the Civil Monetary Penalties Law and the False Claims Act.

Overpayments 40

Overpayments Overpayment Fraud Medicare 40

Healthcare Law Blog

JANUARY 5, 2023

The Proposed Rule includes changes on an array of topics including: Star Ratings, medication therapy management, marketing and communications, health equity, provider directories, coverage criteria, prior authorization, behavioral health services, identification of overpayments , requirements for valid contract applications, and formulary changes.

Medicare 52

Medicare Medicare Medicaid Medicaid 52