Medicare Overpayment

A Medicare overpayment notification indicates that the government believes it overpaid the practice for services provided. This situation not only impacts financial standing but also compliance with federal regulations, making it important for healthcare providers to...

Allegations by federal or state authorities that a healthcare organization has received a Medicare overpayment can lead to a challenging period marked by intense scrutiny and potential legal consequences. It is imperative to approach this situation with a strategic...

Physicians and other healthcare providers are wise to take note of the high likelihood of a crackdown on Medicaid overpayments in New York. A more aggressive approach towards recouping funds is likely after the release of a follow-up report on a New York State...

The government recently announced the findings of a series of audits conducted on Medicare billing from 2011 through 2013. The audits allegedly find that the government overpaid various organizations more than $12 million in claims during this relatively short time...

The government is building an aggressive case against physicians and medical practices who received payment from the Centers for Medicare and Medicaid Services (CMS) for treating patients with amniotic fluid injections like Fluid Flow treatments. The agency has sent...

The Department of Health and Human Services, Office of the Inspector General (OIG), recently released conducted an audit of Medicare claims from Telehealth Service Providers during the first year of the pandemic. The group reports that of the 742,000 providers who...

Dual-eligible individuals are those who qualify for both Medicare and Medicaid coverage. In these situations Medicare generally covers the first 80% of an approved claim and Medicaid covers the remaining 20%. The Office of the New York State Comptroller recently dug...

The feds have accused the home-based healthcare services providers of billing for laboratory and diagnostic testing from 2010 through 2015 that was not reasonable or necessary for the diagnosis or treatment of an illness or injury. As a result, the government argues...

The United States Department of Health and Human Services (HHS) Office of the Inspector General (OIG) recently reported that a number of hospitals received millions in Medicare overpayments. The OIG stated one of these hospitals was located within Northwell Health’s...

There are circumstances that result in a surgeon needing to perform two procedures in one day. Unfortunately, unless certain criteria are met, the surgeon in this position could find themselves accused by the feds of fraudulent billing practices. Case example: OIG...