Remove Electronic Medical Records Remove Fraud Remove Medicaid Remove Overpayment
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2024 Final Rule: CMS Announces More Changes to Medicare Advantage but Declines to Reform the “60 Day Rule”

Health Care Law Brief

On April 5, the Centers for Medicare & Medicaid Services (“CMS”) released the 2024 Medicare Advantage and Prescription Drug Benefit Programs Final Rule (“Final Rule”), which will be codified at 42 C.F.R. 405.986) or “reliable evidence” of fraud or “similar fault” (as defined in 42 C.F.R. Parts 417, 422, 423, 455, and 460.

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Part 3: Audit Documentation to Avoid Potential Appeal Consequences

AIHC

Due to the huge volume of claims payers receive to process, deny and pay, they have implemented various methods to track providers to detect potential waste, fraud and/or abuse. It can result in a situation where insurance opens an investigation or decides to initiate periodic audits on your claims and records. They can, sometimes!

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Health Provider News – October 7, 2022

Hall Render

Judge orders Anthem to face lawsuit over alleged Medicare overpayments. Medical groups want lawmakers to bolster safety for health care workforce. University of Florida, Jupiter Medical Center to build hospital. Local Jax health care provider settles fraud allegations by paying $700,000. Million Health Care Fraud.