Report on Medicare Compliance 29, no. 10 (March 16, 2020) -
? Millennium Physicians Association PLLC, which owns two sleep centers in the Houston area, has paid $1,248,964 to settle false claims allegations over sleep...more
Report on Medicare Compliance 29, no. 6 (February 17, 2020) -
Tenet Healthcare Corp. and an affiliated hospital, Desert Regional Medical Center, have agreed to pay $1.41 million to settle False Claims Act (FCA)...more
2/19/2020
/ Compliance ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Hospitals ,
Kickbacks ,
Medicaid ,
Medical Equipment ,
Medicare ,
Physicians ,
Settlement ,
TRICARE ,
Unnecessary Medical Procedures ,
Whistleblowers
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
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. 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
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