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Two Healthcare Organizations Caught Up in Medicare Fraud Schemes

Compliancy Group

Fraud in healthcare has run rampant in recent years, as evident by two incidents in which healthcare organizations billed insurance companies for things patients never received. In the other fraud scheme, Medicare patients were billed an estimated $2 billion for urinary catheters they never received.

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What Is Medical Billing Compliance?

Compliancy Group

One of the most common ways for providers and healthcare organizations to run afoul is to incorrectly or illegally bill and code for services or supplies. No matter the intent, noncompliance in medical billing can have severe consequences. It pays to know the law and avoid temptations to cut corners.

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Lawsuit Alleges Obamacare Plan-Switching Scheme Targeted Low-Income Consumers

Kaiser Health News

In turn, sales agents used the information to either enroll them in ACA plans or switch their existing policies without their consent. Such private sector platforms, which must be approved by the Centers for Medicare & Medicaid Services, streamline enrollment by integrating with the federal ACA marketplace, called healthcare.gov.

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Orthopedic Billing Compliance Checklist – A Guide for Healthcare Providers

Medisys Compliance

Compliance with Regulatory Guidelines Ensure that all claims are submitted per all applicable laws and regulations, including the Health Insurance Portability and Accountability Act (HIPAA), the Affordable Care Act (ACA), and the Medicare Fraud, Waste, and Abuse (FWA) laws.

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Health Provider News

Hall Render

face growing challenges to stay open KENTUCKY BehaVR merges with New York City-based Fern Health For years, a powerful Louisville hospital sued people for unpaid bills. 11 Plan To Slash $1.5B 11 Plan To Slash $1.5B cash Tenet’s $2.4B

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Health Provider News

Hall Render

Artificial Intelligence Poses Threat to Patient Privacy Bill for Rural Hospital Cyber Skills Passes Senate Committee Chemotherapy shortages push cancer centers toward crisis CMS estimates national spending on hospital care grew just 0.8%

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Health Provider News – August 19, 2022

Hall Render

Stockton Doctor and Medical Practice Agree to Pay Nearly $2 Million to Resolve Allegations of Health Care Fraud. New Colorado Mountain Medical program helps employees grow into health care industry. UnitedHealth Group buys Medicare insurer in Texas. Medical billing vendor data breach affects more than 942,000 patients.