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The pandemic fueled change in our family lives, our working lives and even the marketplace as a whole. The pandemic changed every marketplace within our communities, from retail to healthcare. One of the most visible changes within the healthcare marketplace is the...
In what the Health and Human Services Office of Inspector General is calling the largest audit penalty every imposed on a Medicare Advantage company, the feds have recently completed and an audit and are calling on the company to pay over $200 million back in Medicare...
An overpayment recovery request from Medicare or a private carrier essentially means the payer is stating that they want their money back. They already sent your group payment for a claim, but now they have decided the payment was either too much or unwarranted. It is...
Pharmacists are, essentially, medication managers. These medical professionals spend years studying and training to provide patients with guidance and information on various medications. In some cases, they may fill prescriptions and discuss benefits and potential...
The United States Department of Health and Human Services (HHS) recently announced updates to its Phase 2 Health Insurance Portability and Accountability Act (HIPAA) Audit Program. These audits aim to check for an entity’s compliance with certain requirements. The...
The United States Department of Health and Human Services (HHS) Office of Inspector General recently released its findings from an audit of an HCA Healthcare owned facility operating out of Las Vegas. According to their findings, the facility owes the feds millions....
The United States Department of Justice (DOJ) continues to crackdown on its fight against illegal kickbacks. The feds are clear in their belief that what it considers bribes within the healthcare industry for medical services or equipment taint the ability to provide...
The government has increased its focus on Medicare overpayments to home health agencies (HHAs). These healthcare facilities can reduce the risk of these allegations by avoiding the most common complaints. The United States Department of Health and Human Services (HHS)...
The United States Department of Health and Human Services Office of Inspector General (OIG) stated in a recent report that it has identified significant overpayments to home health agencies (HHAs). The agency states that these overpayments are primarily from improper...
