Back to the Basics, Other Payment Integrity Strategies Post-PHE
RevCycleIntelligence » Medicare Fraud
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1M ago
Back to the Basics, Other Payment Integrity Strategies Post-PHE After an unprecedented three years, it’s time to return to the basics, according to Jordan Kearney, partner at Hooper, Lundy, and Bookman and founder of the firm’s Medicare Audits and Appeals Practice Group. By that, she means ..read more
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Eye Specialists Pay $17M to Resolve False Claims Act Violations
RevCycleIntelligence » Medicare Fraud
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1y ago
Eye Specialists Pay $17M to Resolve False Claims Act Violations SouthEast Eye Specialists, SouthEast Eye Surgery Center, and the Eye Surgery Center of Chattanooga (SEES) must pay $17 million to the United States and Tennessee to resolve allegations that they ..read more
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CMS Proposes 2.8% Medicare Hospice Payment Bump
RevCycleIntelligence » Medicare Fraud
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1y ago
CMS Proposes 2.8% Medicare Hospice Payment Bump Medicare hospice payments could grow by as much as 2.8 percent, or $720 million, next year under a rule recently proposed by CMS. The federal agency released the proposed rule on Friday. It seeks to ..read more
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CMS Announces Start Date for IRF Claims Review Demo
RevCycleIntelligence » Medicare Fraud
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1y ago
CMS Announces Start Date for IRF Claims Review Demo Inpatient rehabilitation facilities (IRFs) will have their Medicare claims reviewed either before or after payment as part of a demonstration CMS intends to take nationwide. CMS recently announced on ..read more
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Lawmakers Ask CMS to Inspect ACO REACH Model to Prevent Fraud, Abuse
RevCycleIntelligence » Medicare Fraud
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1y ago
Lawmakers Ask CMS to Inspect ACO REACH Model to Prevent Fraud, Abuse A group of lawmakers, spearheaded by US Senator Elizabeth Warren (D-Mass.) and Representative Pramila Jayapal (D-Wash.), has asked CMS to examine the ACO REACH model to prevent organizations with a ..read more
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DOJ Alleges Methodist Violated False Claims Act, Anti-Kickback Laws
RevCycleIntelligence » Medicare Fraud
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1y ago
DOJ Alleges Methodist Violated False Claims Act, Anti-Kickback Laws The US Department of Justice (DOJ) has filed a lawsuit against Methodist Le Bonheur Healthcare and Methodist Healthcare Memphis Hospitals, alleging that the health systems violated the False Claims Act ..read more
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Home Healthcare Company Settles False Claims Act Violations
RevCycleIntelligence » Medicare Fraud
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1y ago
Home Healthcare Company Settles False Claims Act Violations Signature HomeNow, a home healthcare company operating in Florida, has reached a $2.1 million settlement to resolve allegations that it violated the False Claims Act and fraudulently billed Medicare ..read more
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Federal Govt Received $1.9B from FY21 Healthcare Fraud Settlements
RevCycleIntelligence » Medicare Fraud
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1y ago
Federal Govt Received $1.9B from FY21 Healthcare Fraud Settlements The federal government received almost $1.9 billion in healthcare fraud settlements and judgments in fiscal year 2021, according to a report from the HHS Office of Inspector General (OIG). The latest ..read more
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Telehealth, EHR Use Increases False Claims Act Violations, Fraud
RevCycleIntelligence » Medicare Fraud
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1y ago
Telehealth, EHR Use Increases False Claims Act Violations, Fraud Healthcare digitization, including increased use of telehealth and EHR has led to a higher volume of healthcare fraud and False Claims Act (FCA) cases, according to lawyers from Hogan Lovells. The ..read more
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Providence Reaches $22.7M Settlement to Resolve Healthcare Fraud
RevCycleIntelligence » Medicare Fraud
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1y ago
Providence Reaches $22.7M Settlement to Resolve Healthcare Fraud Providence Health & Services Washington (Providence) has reached a $22.7 million settlement to resolve healthcare fraud allegations that it falsely billed Medicare and Medicaid for medically ..read more
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