In Coding
Jul 23rd, 2019
Bay City, Michigan surgeon Vasso Godiali, MD, was indicted on July 10, 2019, for allegedly orchestrating a $60 million healthcare fraud scheme. He is also charged with money laundering for financial transactions involving almost $50 million in proceeds from the scheme. The indictment comes from both the federal government and Michigan state authorities because it ...
In CMS
Jun 28th, 2019
Conduit alleges whistleblower lawsuit and feds agree. The Department of Justice (DOJ) intervened in a whistleblower lawsuit against Questcor Pharmaceuticals, now a part of Mallinckrodt ARD LLC, formerly known as Mallinckrodt ARD Inc. The federal government alleges that the drug company Mallinckrodt engaged in fraudulent behavior that directly violates the False Claims Act by using a ...
The Department of Justice (DOJ) Criminal Division issued, April 30, a 19-page document entitled Evaluation of Corporate Compliance Programs. This document applies broadly to all industries where compliance is integral to operations and is not targeted specifically to healthcare. Know what prosecutors are measuring should your organization be charged with noncompliance. Three Overarching Questions ...
Apr 8th, 2019
We’ve all heard of opioid addicts who make up aches and pains, fake injuries, or hurt themselves in hopes of being prescribed Vicodin, Percocet, etc. As the opioid crisis’ grows, so do its boundaries, with family pets becoming its next victims. For example, opioid addicted owners will sometimes hurt their pets to get a veterinary ...
In Audit
Mar 5th, 2019
Separately billing routine evaluation and management (E/M) services provided on the same day as another medical procedure is typically denied by Medicare. Healthcare providers may sometimes separately bill E/M services if they meet certain criteria and append modifier 25 Significant, separately identifiable evaluation and management service by the same physician or other qualified health care ...