Med-Net Compliance

JUNE 15, 2022

California Attorney General Rob Bonta announced a settlement against a Southern California doctor for submitting false claims to Medicare and Medi-Cal between the years of 2011 and 2018 for drugs, procedures, services, and tests that were never administered to patients. In October 2021, the California Department of Justice’s?

Fraud 59

Fraud Doctors Elder Abuse Medicare 59

Health Care Performance

JULY 20, 2022

A New York ENT physician was convicted of filing false claims with Medicare and Medicaid. The physician submitted claims totaling about $585,000 to Medicare and Medicaid and was paid roughly $191,000. The fraudulent act was upcoding of ear exams or ear wax removal to an incision procedure of the external ear.

Fraud 52

Fraud Compliance Medicaid Medicaid 52

Provider Trust

JANUARY 26, 2022

It’s no secret–when fraud enters healthcare, things get risky. But how exactly does the HHS-OIG (Office of Inspector General), the main body responsible for conducting investigations into suspected fraudulent activity, address healthcare fraud and assess future risk of these bad actors? Department of Justice (DOJ), the U.S.

Fraud 52

Fraud US Department of Health and Human Services Medicaid Medicaid 52

AIHC

MAY 31, 2022

Health care insurance fraud is a pressing problem, causing substantial and increasing costs in medical insurance programs. To combat fraud and abuse, all levels within a medical practice, hospital or health care organization must know how to protect the organization from engaging in abusive practices and violations of civil or criminal laws.

Fraud 52

Fraud Compliance Officers Compliance Medicare 52

AIHC

NOVEMBER 29, 2023

Health Care from a Global Perspective, 2022: Accelerating Spending, Worsening Outcomes indicates that in 2021 the U.S. A claim would be generated and submitted to the payer. As the cost of providing care grew, payers started instituting methods to curb expenses and how claims were paid. Why this Trend of Value-Based Care?

Medicare 59

Medicare Medicare Medicaid Medicaid 59

AIHC

NOVEMBER 29, 2023

Health Care from a Global Perspective, 2022: Accelerating Spending, Worsening Outcomes indicates that in 2021 the U.S. A claim would be generated and submitted to the payer. As the cost of providing care grew, payers started instituting methods to curb expenses and how claims were paid. Why this Trend of Value-Based Care?

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Hall Render

NOVEMBER 28, 2023

The data purported to show reimbursement exceeded costs by 45%, which CMS used to support its claim of “high profit margins.” 7,215 2021 5,532 77.5% This could be what is driving the absolute numbers in each category down. Hospice Risk-Screening Category. 7,872 2018 5,851 77.1% 7,589 2019 5,871 79.3% 7,137 2022 4,770 78.0%

Medicare 40

Medicare Medicare Payment Systems Medicaid 40