Healthcare Compliance Blog

JUNE 9, 2022

Between 2017 and 2019, the man, through a group of pain clinics he controlled, caused the submission of false claims for payment to Medicare. If a provider identifies billing mistakes in the course of those audits, the provider must repay overpayments to Medicare and Medicaid within 60 days to avoid False Claims Act liability.

US Department of Health and Human Services 59

US Department of Health and Human Services Overpayments Overpayment Medicare 59

Healthcare Law Blog

FEBRUARY 9, 2024

The ChristianaCare Lawsuit Sherman’s 2017 complaint alleged that ChristianaCare provided prohibited remuneration to Neonatology Associates, a private physician group with an exclusive contract to manage all care in Christiana Hospital’s Neonatal Intensive Care Unit (NICU).

Hospitals 52

Hospitals Compliance Officers Compliance Overpayments 52

HIT Consultant

JANUARY 16, 2023

These players have a wealth of consumer data at their disposal, and those in the retail space have existing locations in some of the most vulnerable areas of the country in terms of access to care (in 2017, 90 percent of Americans lived within 10 miles of a Walmart compared to 82 percent who lived the same distance from a hospital).

Nurses 98

Nurses FDA Overpayments Overpayment 98

Healthcare Law Blog

SEPTEMBER 28, 2023

Refresher on the RADV Final Rule The Final Rule will implement the following changes: CMS will extrapolate RADV audit findings beginning with payment year (“PY”) 2018, and will not extrapolate RADV audit findings for PYs 2011 through 2017, though it will continue to collect the non-extrapolated overpayments that are identified.

Medicare 52

Medicare Medicare Overpayments Overpayment 52

Hall Render

DECEMBER 11, 2024

Changes to Reinstatements In 2017, OIG finalized regulations implementing a process that allows individuals and entities excluded under section 1128(b)(4) of the Act to request reinstatement before regaining the license that was lost and on which the exclusion is based (referred to as early reinstatement) under two sets of circumstances.

Compliance 40

Compliance Licensing Nurses Medicaid 40

CMS.gov

NOVEMBER 16, 2018

We are proud to announce that the Medicare Fee-for-Service (FFS) improper payment rate is at its lowest since 2010 and the decreased improper payment rate from 2017 to 2018 represents a $4.59 These improper payments may be overpayments or underpayments and do not necessarily represent expenses that should not have occurred.

Medicare 20

Medicare Medicare Overpayments Overpayment 20

Hall Render

JUNE 22, 2022

CMS cites to 2017 to show that from 2017 to today, agencies have reduced the number of visits per episode by 16%. CMS states a temporary adjustment is necessary to offset this overpayment. CMS explains that its conclusion that costs are 34% less than reimbursement is correct for two reasons.

COVID-19 40

COVID-19 Payment Systems Medicare Medicare 40

Hall Render

MAY 10, 2024

Vincent reopens Westside Crossing Walk-In Care Indiana’s 2017 abortion law violates free speech, federal judge rules Ind. Parkview Hospitals Awarded ‘A’ In Hospital Safety Grades From Leapfrog Group New nurse apprenticeship program starts at Ascension St.

Nursing Homes 40

Nursing Homes Nurses Hospitals Medicaid 40

Kaiser Health News

JUNE 29, 2022

They also called for the Centers for Medicare & Medicaid Services, or CMS, to revive a foundering audit program that is more than a decade behind in recouping billions in suspected overpayments to the health plans, which are run mostly by private insurance companies. Bliss said Medicare paid $2.6

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Medicare Medicare Governance Overpayments 107