article thumbnail

HHS OIG: 2 in 5 Medicare beneficiaries used telehealth during first pandemic year

Healthcare It News

Department of Health and Human Services Office of Inspector General released a study examining how Medicare beneficiaries used telehealth during the first year of the COVID-19 pandemic. What compelled the team to look into beneficiaries' use of telehealth? This past month, the U.S.

Medicare 257
article thumbnail

Vendor notebook: New AI partnerships with Dell, Google enhance workflows and communications

Healthcare It News

Northwestern Medicine, the Nevada Health Link, Cohere Health and Kyruus Health are partnering withDell Technologies, Google Cloud Marketplace and others to offer providers and payers ways to tackle the daily challenges that delay care approvals and prevent patients from seeking care and enrolling in health plans.

Insiders

Sign Up for our Newsletter

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

article thumbnail

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.

Fraud 52
article thumbnail

What Compliance Officers Need to Know About Stark Laws in Healthcare

Compliancy Group

Many compliance violations in healthcare arise from financial conflicts of interest, particularly when providers get kickbacks or achieve financial gain from their referral services. Department of Health and Human Services, enforces the Stark Law. CMS Updates in 2023 : Voluntary self-referral disclosure laws.

article thumbnail

Wrongly Denied Claims by Private Medicare Plans

Medisys Compliance

Recently published watchdog report found that private Medicare plans routinely rejected claims that should have been paid and denied services that reviewers found to be medically necessary. For detailed understanding we shared observations of OIG where they found that some of the claims were wrongly denied by private Medicare plans.

article thumbnail

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.

article thumbnail

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. Department of Health and Human Services Office of Inspector General, in a statement. have also agreed to pay up to $20.3

Fraud 192