Article Fraud Governance Overpayment 
Healthcare IT Today
MAY 5, 2023
The following is a guest article by Erin Rutzler, Vice President of Fraud, Waste, and Abuse at Cotiviti In Delaware, more than 250 Medicare patients underwent unnecessary genetic testing based on telehealth consultations that often lasted less than two minutes— costing Medicare thousands of dollars per patient. In 2021, a U.S.
AIHC
APRIL 5, 2022
Written by: AIHC Blogger This article provides educational information related to mitigating the risk of an unwarranted payer investigation. This is the final article in a 3-part series on denials and appeals management. Only appeal claims when you have evidence and supporting documentation to substantiate your right to payment.
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YouCompli
SEPTEMBER 13, 2023
Mitigating fraud, waste, and abuse (FWA) is taking on a new urgency for healthcare compliance professionals. Enforcement agencies are prioritizing efforts to deter FWA as more individuals enroll in government healthcare programs like Medicare and Medicaid, and telehealth services continue to evolve post-pandemic.
Healthcare Law Blog
FEBRUARY 9, 2024
Global billing or collaborative care arrangements are not per se violations of the Anti-Kickback Statute, however, there is greater fraud and abuse risk in these types of arrangements unless there is active, ongoing monitoring for compliance. The article refers to all entities as ChristianaCare consistent with Defendants’ briefing. [2]
AIHC
OCTOBER 23, 2024
The information provided in this article is not comprehensive and not intended as consulting or legal advice. Corrective action includes refunding overpayments revealed during the audit. Federal law requires entities repay any overpayments received from Medicare or a State Medicaid program within 60 days after identification.
Healthcare IT Today
FEBRUARY 17, 2023
government and calls for better oversight , the Centers for Medicare & Medicaid Services announced in early February that it would investigate overbilling by those plans. This article focuses on the relatively young technologies that enable CMS to uncover overbillings, whether they be errors or fraud.
AIHC
SEPTEMBER 5, 2023
This article is not intended as legal or consulting advice. If your practice is currently using a telebehavioral health approach for patient treatment, or if you organization is considering implementing this approach, we hope this article will give some food-for-thought on the topic.
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