Call Our NYC Office: 800-761-5190
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...
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...
