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These are the compliance issues providers should be preparing for, post-PHE

Healthcare IT News - Telehealth

The Department of Health and Human Services once again (for the ninth time) extended the public health emergency this past month , stretching it beyond mid-July. But sooner or later, that provision of the Public Health Service Act will draw to a close. We spoke recently with Allison M.

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Medicare Audit Claims University of Miami Hospital Owes Government $3.7 Million

The Health Law Firm

Board Certified by The Florida Bar in Health Law The University of Miami Hospital allegedly owes Medicare $3.7 This is according to an audit report of the hospital’s billing practices that found the hospital allegedly overbilled the health care program in 2009 and 2010. Indest III, J.D.,

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Pennsylvania Man Excluded from All Federal Healthcare Programs for 22 Years 

Healthcare Compliance Blog

His exclusion means that no federal healthcare program payment may be made, either directly or indirectly, for any items or services furnished by him or at his direction or prescription. Between 2017 and 2019, the man, through a group of pain clinics he controlled, caused the submission of false claims for payment to Medicare.

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Compliance Risks Associated with Outlier Payments 

YouCompli

Most federal healthcare payors such as Medicare and Medicaid reimburse most providers on a prospective basis. This is why Medicare publishes its rules on their Inpatient Prospective Payment System (IPPS) or its Outpatient Prospective Payment System (OPPS). The inflated charges resulted in inappropriate outlier payments from Medicare.

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Improving Patient Care With a “Prevent, Detect, Report” Strategy  

YouCompli

Enforcement agencies are prioritizing efforts to deter FWA as more individuals enroll in government healthcare programs like Medicare and Medicaid, and telehealth services continue to evolve post-pandemic. In addition, CMS education and outreach focuses on preventing, detecting, and reporting Medicare fraud and abuse.

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Health Provider News

Hall Render

Report: Amazon Pauses 50-State Virtual Care Service Expansion UnitedHealth acquires Amedisys for $3.3B after home health provider reneges on Option deal Will the doctor see you now? Maybe not amid the changing healthcare landscape in the US. Here’s why.

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Health Provider News

Hall Render

NATIONAL 5 numbers on the rise of Stark law violations 3 takeaways on the new federal data privacy proposal after its first public showcase 80% of Change Healthcare restored after cyberattack Authentication failure blamed for Change Healthcare ransomware attack Biden administration issues new rule to protect privacy of those seeking reproductive health (..)