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
Report on Medicare Compliance 28, no. 38 (Oct. 28, 2019) -
- Doctors Hospital of Augusta in Georgia agreed to pay $180,000 in a civil monetary penalty settlement over alleged violations of the Emergency Medical Treatment...more
10/28/2019
/ Artificial Intelligence ,
Centers for Medicare & Medicaid Services (CMS) ,
Civil Monetary Penalty ,
EMTALA ,
Enforcement Actions ,
Federal Health Care Programs (FHCP) ,
Fraud Risk Indicator ,
Health Care Providers ,
Hospitals ,
Integrity Policies ,
Medicare ,
OIG ,
Physicians ,
Request For Information ,
Statutory Violations ,
Value-Based Care ,
Work Plans
California physician Donald Woo Lee was found guilty Oct. 17 for his role in providing medically unnecessary procedures to Medicare beneficiaries, upcoding, and repackaging single-use catheters for re-use, the Department of...more
10/22/2019
/ Coding ,
Consent Order ,
Criminal Prosecution ,
Department of Health and Human Services (HHS) ,
False Claims Act (FCA) ,
Fraud ,
Guilty Pleas ,
Healthcare Fraud ,
Home Health Care ,
Medical Devices ,
Medicare ,
Medicare Part B ,
OIG ,
Physicians ,
Risk Controls ,
U.S. Attorney ,
Unnecessary Medical Procedures ,
Work Plans
- 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
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