YouCompli

MARCH 22, 2023

There has been significant enforcement over the last couple years relating to overpayments for UDT. The overpayment rate for definitive drug testing for 22 or more drug classes was over 71%. The government argued that before ordering definitive UDT, a provider first needs to review the results of the presumptive test.

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Overpayments Overpayment Compliance Medicare 52

YouCompli

FEBRUARY 22, 2023

Raising prices on your hospital’s chargemaster can also raise your level of compliance grief. Compliance officers can help protect revenue and reduce the risk of penalties by collaborating with the Finance and Reimbursement departments to navigate the dynamics of outlier payments and prospective repayment.

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Compliance US Department of Health and Human Services Overpayments Overpayment 52

YouCompli

NOVEMBER 1, 2023

As compliance officers, we are continually placed in a position to influence the actions of others and help shape our organization’s compliance culture. One way to change that perception is to avoid creating “gotcha” moments when you’re working on a compliance-related matter. Here are four tips that will help.

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Compliance US Department of Health and Human Services Compliance Officers Overpayments 52

Healthcare Law Blog

FEBRUARY 3, 2023

New Subpart 521-1: Compliance Programs The adopted regulations represent substantial changes to 18 N.Y.C.R.R. New Subpart 521-1: Compliance Programs The adopted regulations represent substantial changes to 18 N.Y.C.R.R. For a second violation, OMIG may increase the penalty to $10,000 per month.

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Medicaid Medicaid Compliance Overpayments 52

Health Law RX

JANUARY 30, 2024

By maintaining a robust compliance program, healthcare companies are better able to identify potential red flags early and to prevent violations of fraud and abuse laws. The DOJ Announcement stresses the importance of investing in strong compliance programs for both the buyers and sellers in business transactions.

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Compliance Due Diligence Fraud Governance 52

YouCompli

OCTOBER 26, 2022

Helping our clinical colleagues feel the urgency of compliance monitoring can be a huge challenge. And the Compliance team simply doesn’t have the clinical expertise to own the monitoring of these requirements. That’s a 41% error rate with an extrapolated overpayment of?$269 Don’t let processes overwhelm clinical colleagues.

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Compliance Compliance Officers Overpayments Overpayment 52

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.

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US Department of Health and Human Services Compliance Officers Compliance Fraud 52