Med-Net Compliance

OCTOBER 21, 2022

The Office of Inspector General (OIG) has recently posted the False Claims Act (FCA) settlements for FY 2022 Q1–Q4 on the risk spectrum. The government’s primary civil tool for addressing healthcare fraud is the FCA. Excluded individuals and entities are listed in the OIG’s exclusions database.

Fraud 59

Fraud Compliance Medicare Medicare 59

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. The case was ? in October 2017?under medical assistant and?his?former?informational

Fraud 59

Fraud Doctors Elder Abuse Medicare 59

AIHC

APRIL 5, 2022

Only appeal claims when you have evidence and supporting documentation to substantiate your right to payment. Read Part 1 entitled “ Managing Denials Is Important to Good A/R Hygiene ” posted March 22, 2022, and Part 2 entitled “ Understanding How Payers Deny Claims. at: [link] Is the date of service (DOS) correct?

Fraud 52

Fraud Compliance Medicare Medicare 52

AIHC

NOVEMBER 29, 2023

A 2022 report from the Commonwealth Fund U.S. 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. We recommend reading Leadership in a Value-Based Care (VBC) Environment in addition to this article.

Medicare 59

Medicare Medicare Medicaid Medicaid 59

AIHC

NOVEMBER 29, 2023

A 2022 report from the Commonwealth Fund U.S. 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. We recommend reading Leadership in a Value-Based Care (VBC) Environment in addition to this article.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Health Law RX

JULY 18, 2023

Information Blocking Background In 2016, the 21st Century Cures Act (Cures Act) made sharing electronic health information (EHI) the new normal in healthcare, with the twin goals of encouraging and incentivizing the free flow of patient information among stakeholders and driving efficiencies in healthcare.

Fraud 52

Fraud Compliance 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.” 7,137 2022 4,770 78.0% 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% 7,215 2021 5,532 77.5%

Medicare 40

Medicare Medicare Payment Systems Medicaid 40