Medicare improperly paid practitioners at a higher non-facility rate for services provided to skilled nursing facility (SNF) or hospital inpatients, leading to over $22 million in over-payments, a report from…
OIG's decision to perform a nationwide audit examining compliance with the Provider Relief Fund's balance billing restriction comes just weeks after new federal rules designed to shield consumers from unexpected…
Inpatient hospital stays have become more expensive to the Medicare program. It's a trend that began even before the COVID-19 pandemic. A new report from the Department of Health and…
I. Introduction Zone Program Integrity Contractors (“ZPICs”) are charged with the responsibility of investigating alleged instances of fraud, waste, or abuse by health care providers. They are authorized to conduct…
The testimony came as the Trump administration continues to purge inspectors general across sectors of the federal government. The U.S. Department of Health and Human Services (HHS) Office of…
Three risks, in particular, are expected to pose a greater liability for providers. As we get ready to say goodbye to another year of audits and investigations, compliance officers around…
More than 700 pages of text make up proposed changes to the federal Stark and anti-kickback statutes. On Wednesday, Oct. 9, federal healthcare officials announced two new proposed rules. While…
Santa Monica, Calif.-based Oceanside Medical Group failed to comply with Medicare requirements when billing for psychotherapy services, according to a report from HHS' Office of Inspector General. The OIG said…
Poor healthcare IT infrastructure has contributed to patient care problems at Indian Health Service (IHS) hospitals, concluded a recent report by the HHS Office of Inspector General (OIG). The report…
That’s the contention of the Department of Health and Human Services’ Office of the Inspector General. An OIG audit discovered 34,664 Medicare claims that contained diagnosis codes indicating the treatment…
Audits performed by the HHS Office of Inspector General (OIG) showed that hospitals received excess Graduate Medical Education (GME) Medicare reimbursement after counting residents and interns as more than one…
The Open Payments database needs to improve the accuracy, precision and consistency of some of its data to ensure doctor financial transparency and help consumers better use the information. That’s…
Medicaid improper payments, including fraud, have spiked in recent years, reaching $37 billion in 2017, according to a government watchdog agency. And the Centers for Medicare & Medicaid Services (CMS)…
A new government report finds that Medicare improperly paid acute care hospitals for outpatient services they provided to patients who were inpatients at other facilities. And now Medicare wants the…
Medicare’s Office of Inspector General (OIG) has issued a sixteen-question survey to many ambulance service suppliers. The survey is focused on SNF patients, and specifically why the ambulance service has…
In 2016, the federal government recovered more than $3.3 billion in healthcare fraud judgments and settlements. On Monday, TeamHealth agreed to pay $60 million to settle allegations that a company…