Report on Medicare Compliance 28, no. 44 (December 16, 2019) -
? Korunda Medical LLC, a Florida-based company that provides primary care and interventional pain management, has agreed to pay $85,000 to settle a potential...more
12/17/2019
/ Centers for Medicare & Medicaid Services (CMS) ,
Compliance ,
Corporate Integrity Agreement ,
Department of Health and Human Services (HHS) ,
Health Care Providers ,
Health Care Violations ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Medical Necessity ,
Medicare ,
OIG ,
Outpatient Prospective Payment System (OPPS) ,
Overpayment ,
Provider Payments ,
Right of Access ,
Settlement
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
Report on Medicare Compliance 28, no. 42 (November 25, 2019)
- In a surprising CMS memo that just surfaced, top CMS attorneys echo the sentiments of the Department of Justice about the limits of enforcement actions based...more
11/26/2019
/ Azar v Allina Health Services ,
Comment Period ,
Compliance ,
Department of Justice (DOJ) ,
Durable Medical Equipment ,
Enforcement Actions ,
Fee-for-Service ,
Guidance Documents ,
Home Health Care ,
Medicare ,
Medicare Part B ,
Notice and Comment ,
Payment Rates
Report on Medicare Compliance 28, no. 41 (November 18, 2019) -
- North Carolina physician Damian Brezinski and his medical group, Wilmington Health, agreed to pay $244,000 to settle false claims allegations in connection...more
11/18/2019
/ Compliance ,
Conflicts of Interest ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Health Clinics ,
Medical Devices ,
Medicare ,
Physician-Owned Distributors ,
Settlement ,
TRICARE ,
Unnecessary Medical Procedures
Report on Medicare Compliance Volume 28, Number 40. (November 11, 2019) -
- In a new Medicare compliance review, the HHS Office of Inspector General (OIG) said Angels Care Home Health in Salina, Kansas, didn’t comply with...more
11/15/2019
/ Change of Ownership ,
Compliance ,
Cybersecurity ,
Department of Health and Human Services (HHS) ,
Enforcement Actions ,
Health Care Providers ,
Health Information Technologies ,
Health Insurance ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Home Health Care ,
Inpatient Prospective Payment System (IPPS) ,
Medical Insurance Codes ,
Medicare ,
NIST ,
OCR ,
OIG ,
ONC ,
Security Risk Assessments
Report on Medicare Compliance 28, no. 40 (November 11, 2019) -
CMS has given the green light to prior authorization for five types of procedures in an attempt to control “unnecessary increases” in these procedures as part...more
11/14/2019
/ Ambulatory Surgery Centers ,
Centers for Medicare & Medicaid Services (CMS) ,
Compliance ,
Health Care Providers ,
Hospitals ,
Inpatient Billing ,
Medical Insurance Codes ,
Medicare ,
Medicare Appeals ,
MPFS ,
OMB ,
Opioid ,
Outpatient Prospective Payment System (OPPS) ,
Outpatient Services ,
Physician Assistants ,
Physician Fee Schedule ,
Physicians ,
Prior Authorization ,
Transparency
Report on Medicare Compliance 28, no. 39 (November 4, 2019) -
? The former CEO of Putnam County Memorial Hospital in Unionville, Missouri, pleaded guilty to one count of conspiracy to commit health care fraud, the Department...more
11/13/2019
/ Blood Tests ,
CEOs ,
Compliance ,
Criminal Convictions ,
Department of Justice (DOJ) ,
Fraud and Abuse ,
Guilty Pleas ,
Healthcare Fraud ,
Hospitals ,
Medicare ,
Medicare Beneficiaries ,
Patient Safety ,
Physicians
Starting Oct. 1, per diem payments to skilled nursing facilities (SNFs) will be more generous on the first few days of a Medicare beneficiary’s stay, and then drop as the stay continues. That’s one of the changes under the...more