In CMS
Nov 14th, 2018
Another opioid pill mill gets busted by the Medicare Fraud Strike Force. A “pain management clinic” in Hialeah, Florida, owned by David Bosch and Tania Sanchez, which operated under the name East Medical Office Inc., unlawfully distributed thousands of pills of oxycodone, during the period of April 2017-May 2018. It was a cash-only clinic, which remained ...
In CMS
Oct 30th, 2018
Thousands of consumers’ files in the Federally Facilitated Exchanges (FFE’s) Direct Enrollment pathway may have been compromised. The Centers for Medicare & Medicaid Services (CMS) said “anomalous activity” was detected in the portal on Oct. 13 and a breach was declared on Oct. 16. CMS issued a press release on Oct. 19. “At this time,” ...
In Billing
Sep 28th, 2018
Health Management Associates, LLC (HMA), a hospital chain that has its headquarters in Naples, Florida will be paying over $260 million to avoid criminal and civil claims associated with a scheme to defraud the government of the United States. In this case, the government alleged that HMA was billing inpatient services when they should have ...
EHR tag game can be dangerous when used to support E/M levels. You might have heard about the dangers of “cloning,” or copying documentation from a previous patient encounter into the current note. Now there’s a new potential danger: Tagging. Here’s what you’ll need to know to be sure you’re not over-coding, based on tags ...
Jul 17th, 2018
If you are wondering where $341,000 of your taxpayer money went, look to former U.S. Department of Health and Human Services (HHS) Secretary Tom Price’s chartered aircraft expenses. On July 13, he resigned due to investigations of his use of chartered aircraft, MilAir, and other government travel-related expenses, which did not comply with federal regulations ...