Health Care Law Brief
JUNE 26, 2022
With this denial, the Overpayment Rule remains in full force and effect, and UnitedHealthcare, among other MA plans, must comply or potentially face False Claims Act (FCA) liability. The Overpayment Rule. The Overpayment Rule, set forth at 42 U.S.C. 29844, 29921 (May 23, 2014). See UnitedHealthcare Insurance Co. 3d 173 (Sep.
Health Law Advisor
AUGUST 25, 2023
It is axiomatic that New York State requires every Medicaid provider to have an “effective” compliance program. These regulations were proposed to implement portions of the New York State 2020-2021 Budget Bill amending the mandatory compliance program requirements. New York Social Services Law § 363-d.
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Innovaare Compliance
MARCH 24, 2024
Poor dispute resolution could lead to compliance risks, reputational damage, and even loss of key providers. Inovaare’s comprehensive suite of HIPAA-compliant software solutions features best-practice regulatory processes to help healthcare organizations sustain audit readiness, reduce non-compliance risks, and lower operating costs.
Florida Health Care Law Firm
DECEMBER 2, 2021
On November 8, 2021, The Department of Health & Human Services (HHS), Office of Inspector General (OIG) released a revised and renamed Provider Self-Disclosure Protocol (SDP), now known as the “Health Care Fraud Self Disclosure “protocol. The OIG recognized that there are benefits to disclose potential fraud.
Innovaare Compliance
MARCH 1, 2022
in 2021 to $170.00 annually on average between 2021 and 2029 compared to 4.4% 6] Improper payments can be overpayments and underpayments. In November 2021, CMS announced a Part C improper payment rate of 10.28% ($23.19 The monthly premium for Medicare Part B rose 14.5%, from $148.50 in Social Security benefits.
Healthcare IT Today
FEBRUARY 2, 2023
Episource works with a regional healthcare organization that has added an annual compliance retrospective in the months leading up to the final submission deadline. In the most recent audit , the organization looked at more than 15,000 beneficiaries in the payment year 2021.
Healthcare IT Today
MAY 5, 2023
In 2021, a U.S. By taking a proactive, data-driven approach to genetic testing fraud, waste and abuse, health plans can protect members from unnecessary testing, prevent inappropriate claims from being paid, and improve their chances of recovery when an overpayment occurs.
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