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Two Healthcare Organizations Caught Up in Medicare Fraud Schemes

Compliancy Group

In one incident, a New Jersey pharmacy admitted to conspiracies to defraud benefits providers, including Medicare and Medicaid, of $65 million for medications never provided to patients. In the other fraud scheme, Medicare patients were billed an estimated $2 billion for urinary catheters they never received.

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Florida woman to pay $20.3M after using telemedicine to shield alleged fraud

Healthcare IT News - Telehealth

Department of Justice announced earlier this month that an Indian Rocks Beach, Florida-based woman has pleaded guilty to conspiracy to commit healthcare fraud and filing a false tax return. In reality, the DOJ alleges, the conspirators had bribed doctors to approve the claims. Kelly Wolfe and her company, Regency, Inc., WHY IT MATTERS.

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Significant Upcoding Risks Emerge with Medicare Advantage

YouCompli

Approximately 65 million Americans are enrolled in Medicare – about 34 million in traditional Medicare and the rest in Medicare Advantage. Traditional Medicare is administered by the federal government, and individuals pay a separate monthly premium for hospital visits, doctors/outpatient, and prescription drugs.

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When Will Self-Service Come to Health Care?

Health Populi

At least one in three people who have tried out virtual health care have done so because they use technology in all aspects of life and want to do the same with their healthcare. A common theme at health care meetings these days is how and when health care will meet its Amazon, Apple, or Uber moment? ” .

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Reactions to the Ascension Healthcare Ransomware Attack and Suggestions for Healthcare Organizations

Healthcare IT Today

Mike Semel, President and Chief Security Officer of Semel Consulting The Ascension health system data breach can’t be easily separated from the United Healthcare Change Health breach that recently caused a huge financial and medical impact across the healthcare sector and may have breached the personal information for a third of Americans.

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Hundreds of industry groups call on Congress to advance permanent telehealth reform

Healthcare IT News - Telehealth

"Much of this transformation is dependent on temporary flexibilities extended to health systems and providers that are limited to the duration of the COVID-19 public health emergency declaration," the letter read. WHY IT MATTERS.

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HHS Findings from Semiannual Report to Congress

American Medical Compliance

In Spring 2022’s Semiannual Report to Congress (SAR), the Department of Health and Human Services’ Office of Inspector General (HHS-OIG) reported that nearly $3 billion had been misspent on Medicare and Medicaid services. HHS Examines Medicare Spending and COVID-19 Tests.