YouCompli

MARCH 22, 2023

There has been significant enforcement over the last couple years relating to overpayments for UDT. In general, there are two major categories of UDT. The overpayment rate for definitive drug testing for 22 or more drug classes was over 71%. What do all these entities and settlements have in common? What is Urine drug testing?

Overpayments 52

Overpayments Overpayment Compliance Medicare 52

Med-Net Compliance

OCTOBER 21, 2022

The government’s primary civil tool for addressing healthcare fraud is the FCA. Most of these cases are resolved through settlement agreements in which the government alleges fraudulent conduct and the settling parties do not admit liability.

Fraud 59

Fraud Compliance Medicare Medicare 59

AIHC

APRIL 5, 2022

Written by: AIHC Blogger This article provides educational information related to mitigating the risk of an unwarranted payer investigation. Audit Coding, Billing and Documentation for Accuracy Insurance carriers and government contractors have the authority to review any claims at any time. Detect a Problem?

Fraud 52

Fraud Compliance Medicare Medicare 52

AIHC

MARCH 28, 2022

Written by: AIHC Blogger This article provides educational information related to fighting unreasonable denials by working through a complex payer appeals process. Government Accountability Office (GAO), improper payments have been estimated to total almost $1.7 trillion government-wide from fiscal years 2003 through 2019.

Medicare 52

Medicare Medicare Compliance Governance 52

Healthcare Law Blog

JANUARY 5, 2023

The Proposed Rule includes changes on an array of topics including: Star Ratings, medication therapy management, marketing and communications, health equity, provider directories, coverage criteria, prior authorization, behavioral health services, identification of overpayments , requirements for valid contract applications, and formulary changes.

Medicare 52

Medicare Medicare Medicaid Medicaid 52