Federal authorities conducted the largest Medicare fraud bust ever in five different states (including Michigan and New York), arresting dozens of suspects accused in scams totaling $251 million. In total, 94 suspects have been indicted and 36 were arrested this morning including doctors and nurses in Detroit, New York City, Miami, Houston and Baton Rouge, […]
Robert A. Vito, Acting Assistant Inspector General, CMS Audits, testified before the Subcommittees on Federal Financial Management of the Senate Homeland Security and Governmental Affairs Committee on Preventing and Recovering Government Payment Errors. In his testimony, Mr. Vito expressed concern over OIG’s June 2010 report on Invalid Prescriber Identifiers on Medicare Part D Drug Claims, […]
A recent doctor survey study by the Journal of American Medical Association (JAMA) found that while physicians support the professional commitment to report all instances of impaired or incompetent colleagues, when faced with these situations, many do not report. Conducted by a team from Massachusetts General Hospital, the study used data from 2009 national survey […]
CMS just released its first in a series of articles that will disseminate information on Recovery Audit Contractor (RAC) high-dollar improper payment vulnerabilities. The objective of such articles is to provide education regarding RAC demonstration-identified vulnerabilities to prevent the same problems from happening in the future. CMS notes two high-risk vulnerabilities identified during the RAC […]
The U.S. Department of Health and Human Services announced its plan to expand the use of electronic health records (EHR) through incentives payments, to improve Americans’ health, increase safety and reduce health care costs. Under the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009, health care professionals and hospitals can qualify […]
Despite all the scrutiny upon providers in terms of submitting accurate claims, a recent study by the American Medical Association (AMA) shows health insurance companies should also be held responsible for improper processing of claims. In the study, the AMA found that one in five medical claims is processed incorrectly by health insurers. Health insurers […]
In addition to the many aspects of the new HIPAA rules modifying the existing HIPAA Privacy and Security Rules, if the proposed rules are finalized, covered entities will be required to make “material modifications” to their Notice of Privacy Practices (“Notice”) therefore triggering obligations to revise and distribute the “new” Notices. For example, covered entities […]
The OIG for the Department of Health and Human Services entered into a Civil Monetary Penalty (CMP) settlement agreement for $7.3 million with United Shockwave Services, United Prostate Centers, and United Urology Centers (collectively, United), all of which are based in the Chicago, Illinois area. This agreement settles charges by OIG alleging that United, and […]
The Department of Health and Human Services (“HHS”) today announced a notice of proposed rulemaking regarding HIPAA Privacy and Security. The proposed rule is issued in connection with the amendments and expansion to HIPAA made as part of the Health Information Technology and Economic Clinical Health Act (the “HITECH Act”), enacted as part of the […]
In a news conference today, organizers of the Michigan Health care reform opt-out announced their petition drive fell short of collecting enough signatures to put the issue before the voters. Wendy Day, one of the organizers for Michigan Citizens for Healthcare Freedom estimated the group’s signature collectors gathered between 145,000-170,000 signatures, well short of the […]
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