H. Lee Moffitt Cancer Center & Research Institute Hospital Inc. in Tampa, Florida, has agreed to pay $19.564 million to settle false claims allegations over claims submitted to federal health care programs for items and...more
2/20/2024
/ Clinical Trials ,
Compliance ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
Enforcement Actions ,
False Billing ,
False Claims Act (FCA) ,
Health Care Providers ,
Healthcare Fraud ,
HIPAA Privacy Rule ,
Medical Records ,
Medicare ,
OCR ,
Provider Self-Disclosure Protocol ,
Settlement
Report on Medicare Compliance Volume 32, no 29 (August 2023)
In a new Medicare transmittal (12,202), CMS introduced a new place of service (POS) code (27) for “Outreach Site/Street.” POS 27 is defined as “a non-permanent...more
Report on Medicare Compliance Volume 32, no 25 (July 2023)
Hospices in four states will face heightened oversight. “CMS is placing newly enrolling hospices located in Arizona, California, Nevada, and Texas in a provisional...more
7/18/2023
/ Centers for Medicare & Medicaid Services (CMS) ,
Compliance ,
False Billing ,
False Claims Act (FCA) ,
Fraud and Abuse ,
Health Care Providers ,
Healthcare ,
Hospice ,
Medicaid ,
Medicare ,
Physicians ,
Settlement
HealthOne Critical Care Transport Service Inc., doing business as MedicOne Medical Response of Marion, Illinois, has agreed to pay $302,124 to settle allegations it improperly billed Medicare for scheduled, non-emergency...more
12/6/2022
/ Ambulance Providers ,
Department of Health and Human Services (HHS) ,
Department of Justice (DOJ) ,
False Billing ,
Healthcare ,
Medical Billing Codes ,
Medicare ,
Non-Emergency Medical Transportation (NEMT) ,
OIG ,
Overpayment ,
Settlement
Report on Medicare Compliance 31, no. 35 (September 26, 2022) -
For the third time in about 2 1/2 years, hospitals or other providers that are part of Dartmouth-Hitchcock Health, a large health system in New Hampshire,...more
9/29/2022
/ Centers for Medicare & Medicaid Services (CMS) ,
Civil Monetary Penalty ,
Department of Health and Human Services (HHS) ,
Diagnostic Tests ,
False Billing ,
Health Care Providers ,
Hospitals ,
Medicaid ,
Medicare ,
OIG ,
Overpayment ,
Physicians ,
Settlement ,
TRICARE
Report on Medicare Compliance 31 no. 29 (August 15, 2022) -
Sanford Health, Sanford Clinic and Sanford Medical Center in South Dakota have agreed to pay $25,842 in a settlement about telemedicine services with the HHS...more
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 30, no. 22 (June 14, 2021) -
A Colorado radiation therapy provider has agreed to pay $3.569 million in a civil monetary penalty settlement with the HHS Office of Inspector General...more
6/16/2021
/ Centers for Medicare & Medicaid Services (CMS) ,
Civil Monetary Penalty ,
Department of Health and Human Services (HHS) ,
False Billing ,
Health Care Providers ,
Hospitals ,
Medicaid ,
Medical Billing Codes ,
Medicare ,
OIG ,
Overpayment ,
Physicians ,
Settlement Agreements
Report on Medicare Compliance 30, no. 14 (April 12, 2021) -
Doctors Care P.A., the largest urgent care provider network in South Carolina, and its management company, UCI Medical Affiliates of South Carolina Inc., will...more
4/15/2021
/ Centers for Medicare & Medicaid Services (CMS) ,
False Billing ,
False Claims Act (FCA) ,
Health Care Providers ,
Inpatient Prospective Payment System (IPPS) ,
Inpatient Quality Reporting ,
Medicaid ,
Medicare ,
Proposed Regulation ,
TRICARE ,
Urgent Care Facilities ,
Whistleblowers
Report on Medicare Compliance 30, no. 2 (January 18, 2021) -
Recovery audit contractors (RACs) may soon be auditing positron emission tomography (PET) for initial treatment strategy in oncologic conditions for compliance...more
1/22/2021
/ Compliance ,
Covered Entities ,
Department of Health and Human Services (HHS) ,
Electronic Medical Records ,
False Billing ,
False Claims Act (FCA) ,
Health Care Providers ,
HIPAA Privacy Rule ,
HIPAA Violations ,
Hospitals ,
Medical Necessity ,
Medical Records ,
Medicare ,
OCR ,
Physicians ,
Recovery Audit Contractors (RACs) ,
Required Documentation ,
Right of Access ,
Settlement Agreements
Report on Medicare Compliance 29, no. 25 (July 13, 2020)
- Ophthalmic Consultants PA in Sarasota, Florida, agreed to pay $4.8 million to settle false claims allegations that it billed Medicare and other federal payers...more
7/21/2020
/ Centers for Medicare & Medicaid Services (CMS) ,
Compliance ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
Durable Medical Equipment ,
False Billing ,
False Claims Act (FCA) ,
Fraud ,
Guidance Update ,
Guilty Pleas ,
Health Care Providers ,
Hospitals ,
Medical Billing Codes ,
Medicare ,
OIG ,
Settlement ,
Telemedicine ,
Work Plans
Report on Medicare Compliance 29, no. 3 (January 27, 2020) -
Mission, Texas, rheumatologist Jorge Zamora-Quezada, M.D., was found guilty by a jury Jan. 15 for his part in a $325 million heath fraud scheme in which he...more
1/30/2020
/ Bodily Injury ,
Centers for Medicare & Medicaid Services (CMS) ,
Chiropractors ,
Compliance ,
Criminal Convictions ,
Emotional Injury Claims ,
False Billing ,
False Claims Act (FCA) ,
False Statements ,
Final Rules ,
Guilty Pleas ,
Healthcare Fraud ,
Medicare ,
Nursing Homes ,
Pain Management ,
Physicians
- Fresenius Medical Care North America Inc. has agreed to pay $5.2 million to settle allegations that it tested dialysis patients for Hepatitis B surface antigen more often than medically necessary and billed Medicare for the...more
10/15/2019
/ Civil Monetary Penalty ,
Enforcement Actions ,
False Billing ,
False Claims Act (FCA) ,
Federal Contractors ,
Health Care Providers ,
Health Insurance Portability and Accountability Act (HIPAA) ,
HIPAA Breach ,
HIPAA Privacy Rule ,
Medical Necessity ,
Medicare ,
OCR ,
Settlement Agreements