YouCompli

DECEMBER 14, 2022

Sharon Parsley, JD, MBA, CHC, CHRC contributes a monthly post on compliance officer effectiveness for the YouCompli blog. Many people in our discipline love the slogan “compliance is everybody’s business.” For me, that has sometimes been the Chief Medical Officer or a physician CEO who really understood what I was trying to do.

Compliance 52

Compliance Compliance Officers Nurses Overpayments 52

Health Care Law Brief

APRIL 12, 2023

Determinations of medical necessity will need to follow national coverage determinations, local coverage determinations, or, where none are applicable, plans must follow publicly available, evidence-based coverage criteria. Final Rule at p. 3729(b)(1)(A) of the False Claims Act (“FCA”). See Proposed Rule at 79559. See 42 U.S.C. See 42 C.F.R.

Medicare 52

Medicare Medicare Overpayments Overpayment 52

AIHC

APRIL 5, 2022

Providers may take documentation “short cuts” or feel overwhelmed with implementation of a new EMR (electronic medical record) system and clone or make documentation errors. If the payer, such as Medicare, performs an extrapolation, reducing each overpayment dollar through appeal can mean thousands less to pay back.

Fraud 52

Fraud Compliance Medicare Medicare 52