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...
It is not uncommon for healthcare providers to receive a demand for overpayment from Medicare. Those who find themselves in this situation may wonder what their options are. In some cases, it may make sense to pay the bill and move on. In others, the amount demanded...
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...
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 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...
The United States Department of Justice (DOJ) recently accused New York health service company Cigna of over $1 billion in Medicare overpayments from 2012 through 2017. The feds state the insurance provider intentionally misrepresented health conditions to justify...
