Hospitals and other providers should brace for recoupment of possibly hundreds of millions of dollars they were reportedly overpaid for services provided under the COVID-19 uninsured program (UIP) in the wake of new audit...more
8/17/2023
/ Audits ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
False Claims Act (FCA) ,
Health Care Providers ,
Hospitals ,
HRSA ,
OIG ,
Overpayment ,
Provider Relief Fund ,
Relief Measures ,
Whistleblower Awards ,
Whistleblowers
Report on Medicare Compliance 31 no. 18 (May 16, 2022)
- In a new report, the HHS Office of Inspector General (OIG) said 25% of Medicare beneficiaries experienced patient harm (adverse events and temporary harm events)...more
5/18/2022
/ Audits ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
False Billing ,
False Claims Act (FCA) ,
Health Care Providers ,
Home Health Care ,
Hospitals ,
Medicare ,
Medicare Beneficiaries ,
OIG ,
Patient Safety ,
Settlement
Report on Medicare Compliance 31, no. 14 (April 18, 2022) -
Michigan gynecologic oncologist Vinay Malviya, M.D., has agreed to pay $775,000 to settle false claims allegations in connection with medically unnecessary...more
4/20/2022
/ Audits ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Health Care Providers ,
Healthcare Fraud ,
Hospitals ,
Medicaid ,
OIG ,
Physicians ,
Settlement Agreements ,
Unnecessary Medical Procedures ,
Work Plans
Report on Medicare Compliance 30, no. 28 (August 2, 2021) -
CMS has not fined any hospitals yet for noncompliance with price transparency requirements, a spokesperson tells RMC. “In April 2021, CMS began issuing warning...more
8/5/2021
/ Audits ,
Centers for Medicare & Medicaid Services (CMS) ,
Civil Monetary Penalty ,
Corrective Action Plans (CAPs) ,
Final Rules ,
Health Care Providers ,
Hospitals ,
Noncompliance ,
Outpatient Prospective Payment System (OPPS) ,
Price Transparency ,
Warning Letters
Report on Medicare Compliance 30, no. 17 (May 3, 2021) -
In a new provider compliance audit, the HHS Office of Inspector General (OIG) said Visiting Nurse Association of Maryland (VNA) received overpayments of $2.1...more
5/6/2021
/ Audits ,
CCJR ,
Centers for Medicare & Medicaid Services (CMS) ,
Compliance ,
Department of Health and Human Services (HHS) ,
Final Rules ,
Health Care Providers ,
Medicaid ,
Medicare ,
OIG ,
Overpayment
Report on Medicare Compliance 29, no. 43 (December 7, 2020) -
In a new provider compliance audit, the HHS Office of Inspector General (OIG) said The Palace at Home, a for-profit home health care agency (HHA) in Miami,...more
12/9/2020
/ Audits ,
Billing ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Health Care Providers ,
Home Health Care ,
Medicare ,
New Guidance ,
OIG ,
Overpayment ,
Required Documentation
Report on Medicare Compliance 29, no. 30 (August 24, 2020) -
Mission Home Health of San Diego Inc. was overpaid $61,718 in 2015 and 2016, which was extrapolated to $5.9 million, according to the latest Medicare home health...more
Report on Medicare Compliance Volume 29, no. 22 (June 15, 2020):
- The HHS Office of Inspector General has updated its Work Plan, and new items include opioid treatment challenges during the COVID-19 pandemic.
- In a...more
6/19/2020
/ Audits ,
Compliance ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
Health Care Providers ,
Hospitals ,
Medicare ,
OIG ,
Opioid ,
Overpayment ,
Work Plans
Report on Medicare Compliance 29, no. 16 (April 27, 2020)
- The HHS Office of Inspector General (OIG) has proposed a rule on civil monetary penalties (CMPs) for information blocking and fraud related to HHS grants, contracts...more
5/5/2020
/ Audits ,
Billing Errors ,
Civil Monetary Penalty ,
Compliance ,
Data Blocking ,
Department of Health and Human Services (HHS) ,
False Claims Act (FCA) ,
Fraud ,
Kickbacks ,
Medicare ,
Medicare Billing Privileges ,
OIG ,
Physicians ,
Psychological Counseling ,
State Attorneys General ,
Telehealth
Report on Medicare Compliance 29, no. 11 (March 23, 2020)
- There are signs of life to the national hospital reviews of short stays and high-weighted MS-DRGs (HWDRGs). A CMS spokesperson said Avar Consulting, a...more
Report on Medicare Compliance 29, no. 5 (February 10, 2020) -
At least two Medicare administrative contractors (MACs) have set their sights on observation services, and there may be more to come. WPS is auditing...more
Report on Medicare Compliance 28, no. 44 (December 16, 2019) -
One way to find out whether compliance and integrity have seeped into the bones of an organization is asking people who would know. There may be a compliance...more
12/16/2019
/ Attorney General ,
Audits ,
C-Suite Executives ,
Compliance ,
Compliance Monitoring ,
Corporate Integrity Agreement ,
Corporate Monitoring ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Executive Compensation ,
False Claims Act (FCA) ,
Fraud and Abuse ,
Incentives ,
Medicare ,
OIG ,
Physicians ,
Stark Law